To properly diagnose an individual with cor pulmonale, a doctor will need to do some blood tests, a chest x-ray, an echocardiogram, and possibly a CT scan of the chest, a right heart catheterization and a ventilation and perfusion scan of the lungs. This article will focus on the tests and how they help the doctor diagnose cor pulmonale.
Blood antibody test – A blood antibody test will identify antibodies that might be in the blood that can trigger the symptoms. This test can help to confirm or rule out the presence of antibodies that might trigger an autoimmune disorder that might be inducing the symptoms of cor pulmonale. Cor pulmonale can be caused by certain autoimmune disorders which can cause pulmonary hypertension. The blood antibody test can determine if there is an autoimmune disorder at fault for the patient’s cor pulmonale symptoms.
Arterial blood gas (ABG) test – An ABG is done to measure one’s level of oxygen and carbon dioxide in the blood. The ABG test tells the doctor how well your body uses oxygen and how well your body gets rid of carbon dioxide. The test also identifies problems with the lung and kidney function as they work together to keep your acid/base balance in check. If your acid/base balance gets too high or too low your body can go into a metabolic state of acidosis or alkalosis, both conditions can become life threatening in people with chronic lung diseases and conditions, such as cor pulmonale.
X-rays and Scans
Chest x-ray – A chest x-ray will show the evidence of pulmonary hypertension when the radiologist reads the x-ray and finds that the right ventricle of the heart is enlarged. The doctor is able to see the general shape and location of the heart as it sits within the medial stinal area of the chest located beneath the area of the sternum.
Echocardiogram – An echocardiogram is an ultrasound image of the heart in real time. The technician uses a special kind of microphone, called a transducer, to press against the skin of your chest in the area of your heart. The ultrasound works through a liquid gel that is applied to the skin. The sound waves travel through the gel into the skin and beyond. The tissues of our body are made up of nearly 80 percent water, so the beam of sound travels through the water and bounces off the solid structure of the heart.
An echocardiogram can measure the size of the heart and the chambers of the heart. The echo can give a picture that is 1 dimensional and 2 dimensional. The technician can section off a piece of the heart and examine it. An echocardiogram allows the doctor to see how each chamber fills with blood and empties the blood through the valves. An echocardiogram can be done at a doctor’s office or it can be done at a hospital.
Prior to the echo being done, the technician will apply EKG leads to your chest so that a running EKG can be done while the test is being done. The doctor will be able to see the heart working and see an EKG at the same time. If there is a problem with the anatomy of the heart, or if there is a problem with the functioning of the heart, the echocardiogram will pick it up.
People who have cor pulmonale often have hypertrophy (enlargement) of the right ventricle (lower chamber) of the heart. The right heart enlargement is caused by pulmonary hypertension and it may lead to failure of the right ventricle, which is also known as right heart failure. More scans and procedures will be discussed in a future article.