case analysis

13 years ago was the basis of chronic bronchitis: sudden changes in winter and spring or climate, repeated attacks, cough and kicking in summer, and a small amount of white sputum at first.

Five years later, it was chronic obstructive pulmonary disease complicated with cor pulmonale (the patient showed signs of heart failure). According to fatigue, he felt flustered and short of breath, and got better after rest.

Cough kicking, cough with white phlegm, which is heavier at night (stimulated by cold air at night)

Mild cyanosis of mouth and lip with facial edema, yellow complexion, pale tongue, thick and greasy fur, bulging jugular vein, liver and neck sign (+) (right heart failure sign).

Mobile dullness (+), no deformity in spine and limbs, no knocking pain in both kidneys, and sunken edema in both lower limbs (++) (signs of right heart failure).

Laboratory examination: oxygen PaO2 _ 2 partial pressure below 60 is respiratory failure, and carbon dioxide PaCO2 _ 2 partial pressure above 50 is type I respiratory failure.

Electrocardiogram: P wave is high and sharp, moving clockwise, and the right ventricle is enlarged.

X-ray examination: pulmonary artery segment is prominent, right ventricular arch is enlarged, lung field permeability is enhanced, and hilar texture is thickened.

Electrocardiogram and X-ray showed pulmonary hypertension.

So integrated:

Chronic bronchitis, chronic obstructive pulmonary disease, pulmonary hypertension, right heart failure, type I respiratory failure.