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Question # 5
Your neighbor with severe chronic obstructive pulmonary disease (COPD) has developed heart failure. Based on his underlying disease, what type of heart failure does he likely have and how did he develop it?
Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases that block airflow and make breathing difficult. The two main factors that cause COPD are emphysema and chronic bronchitis. “In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. In chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe. (What is chronic obstructive pulmonary disease?)”. Patients with COPD are diagnosed by a physical examination, chest radiograph, pulmonary function test, blood gas analysis CT scan and arterial blood gases (Huether and McCance, Pg. 683 and 684). Treatment of COPD includes the use of inhaled anticholinergic, beta agonist, and corticosteroids. Pulmonary therapy, improved nutrition and breathing techniques can improve symptoms. If those treatments fail, then oxygen therapy must be started to ensure the patient is not hypoxic.
When a patient develops COPD, they are at a higher risk of developing pulmonary hypertension that will eventually lead to Cor Pulmonale. This means that the patient will have right ventricular enlargement because of the hypertension. This condition exerts chronic pressure overload in the right ventricle that causes hypertrophy. This eventually progresses to dilation and failure of the ventricle (Huether and McCance, Pg. 700).
Every patient I have ever taken care that was diagnosed with COPD has always had to use

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