Complication of COPD

Complication Respiratory Failure (RF) Chronic RF PO2 < 60 mmHg; PCO2 > 60 mmHg; normal pH Acute on chronic RF dypsnea, increase sputum and purulen, fever, altered mental state

Recurrent infection due to increase sputum production Cor pulmonale P pulmonal on ECG, hematocrit > 50 %

COPD Hypoxemia, hypercapnea, acidosis Pulmonary vasoconstriction Pulmonary Hypertension Increase RV afterload RVH

Symptoms (1)Fatigue Tachypnea Exertional dyspnea Cough Anginal chest pain due to right ventricular ischemia (it usually does not respond to nitrates) or pulmonary artery stretching Hemoptysis rupture of a dilated or atherosclerotic pulmonary artery

Symptoms (2) Hoarseness Anorexia, right upper quadrant abdominal discomfort, and jaundice (passive hepatic congestion secondary to severe right ventricular failure) Syncope with exertion (relative inability to increase cardiac output during exercise) Peripheral edema (increase the hydrostatic gradient)

Reference PPOK (PEDOMAN DIAGNOSIS & PENATALAKSANAAN DI INDONESIA) PDPI 1997-2003 Global Initiative for COLD (GOLD updated 2010) http://emedicine.medscape.com/article/807 143-clinical