Does chronic lung disease cause heart failure? Hong Anh (37 years old, Ninh Binh)

Answer:

Your father is a typical case of chronic obstructive pulmonary disease (COPD) causing cardiovascular complications. Although COPD is a respiratory disease, if not well-controlled, it can severely affect the heart, especially the right ventricle – the heart chamber responsible for pumping blood to the lungs for gas exchange.

When the lungs are damaged by COPD, the alveoli and surrounding capillaries are also affected, hindering blood flow through the lungs. The right ventricle, which is responsible for pumping blood into the pulmonary circulation, is forced to work at a higher pressure to overcome this obstacle. This increased pressure over a long period causes the right ventricle to dilate and gradually weaken.

The most obvious symptom of right-sided heart failure is swollen feet (pitting edema), distended neck veins, and an enlarged liver. In later stages, there may also be fluid accumulation around the lungs (pleural effusion) or in the abdomen (ascites). This complication is called cor pulmonale, and it often appears in long-term COPD patients, especially the elderly.

Heart disease in cor pulmonale does not stem from primary cardiovascular disease but is a secondary consequence of prolonged increased pressure in the pulmonary circulation. Therefore, someone with no history of heart disease, like your father, can still develop heart failure due to COPD.

To determine the extent of right heart damage, doctors may order an echocardiogram, measure pulmonary artery pressure, or use cardiac catheterization in some cases. Treatment requires a combination of bronchodilators, diuretics, respiratory support, and management of risk factors that trigger acute episodes.

Your family should take him to both respiratory and cardiology specialists for concurrent monitoring and regular assessment of cardiopulmonary function. Controlling COPD not only helps improve breathing but also reduces the burden on the heart, preventing the progression of heart failure.

Dr. Nguyen Quang Doi

Deputy Head of Respiratory Department

Tam Anh General Hospital, Ha Noi