A patient with cor pulmonale may have no or little pain during an acute myocardial infarction. Zhao et al identified clinical findings that may be seen in a patient with cor pulmonale and acute myocardial infarction. The authors are from Chinese PLA (Peoples' Liberation Army) General Hospital in Beijing.


Conditions that may precede an acute myocardial infarction in a patient with cor pulmonale:

(1) acute infection, especially pneumonia

(2) hypoproteinemia

(3) anemia


Clinical findings:

(1) The patient may experience little or no pain.

(2) Acute left ventricular failure with pulmonary edema and/or heart failure may be the only finding. Dyspnea may be the only symptom.


When caring for a patient with cor pulmonale it is important to evaluate the patient for acute myocardial infarction if anemia, dyspnea, heart failure or infection occur, even in the absence of chest pain.


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