Occupational respiratory diseases. Merchant JA, Bochlecke BA, Taylor G, eds. Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 86-102, 1986 Sep; :719-736
Cor pulmonale is reviewed with regard to its occupational epidemiology, pathology, etiology, clinical diagnostic criteria, methods of prevention, and research needs. The definition of cor pulmonale is heart failure caused by lung disease. Acute cor pulmonale is associated with disorders that induce severe alveolar hypoxia including pulmonary edema associated with toxic exposures to silica dusts (7631869), asbestos (1332214), beryllium (7440417), tungsten-carbide (12070121), antigenic agents causing allergic alveolitis, cadmium (7440439), graphite (7782425), hemp, and coal and uranium mine dusts. Occupational exposures associated with emboli and obliterative lesions have also been identified as contributing to the disease. Acute cor pulmonale is usually attributed to embolism or acute pulmonary edema. Chronic cor pulmonale is associated with pulmonary hypertension and right ventricular hypertrophy. Systemic venous congestion is common. Complications of the disease are difficult to treat when the increase in pulmonary vascular resistance is due to blood vessel destruction as in cases of silicosis. Early diagnosis is difficult. The most definitive method for detection, cardiac catheterization, is unsuitable for mass screening. Other methods such as echo cardiography, x-rays, and physical examination are appropriate only late in the progression of the disease. The suggested method for the prevention of cor pulmonale is avoidance of contact with any toxic fume or gas that produces acute pulmonary edema.
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