Cor pulmonale is failure of the right side of the heart brought on by long-term high blood pressure in the pulmonary arteries and right ventricle of the heart.
Right-sided heart failure
Normally, the left side of the heart produces a higher blood pressure in order to pump blood to the body. The right side of the heart pumps blood through the lungs under much lower pressure.
High blood pressure in the arteries of the lungs is called pulmonary hypertension. The right side of the heart has a harder time pumping blood when this happens. If this high pressure is present for a longer period of time, it puts a strain on the right side of the heart, leading to cor pulmonale.
Almost any chronic lung condition that causes prolonged low blood oxygen levels can lead to cor pulmonale. A few of these causes include:
If a lung problem is not the cause, it is called idiopathic cor pulmonale.
Shortness of breath or light-headedness during activity is often the first symptom. You may have a fast heart beat and feel like your heart is pounding.
Over time, symptoms occur with lighter activity or even while at rest. They may include:
The health care provider will perform a physical exam. This may reveal:
The following tests may help diagnose cor pulmonale:
The goal of treatment is to control symptoms. It is important to treat medical disorders that cause pulmonary hypertension, which can lead to cor pulmonale.
Many new treatment options are becoming available. Medicines that may be prescribed include:
Your doctor will decide which medicine is best for you. You will be closely monitored during treatment to watch for side effects and to see how well the medicine works for you. Never stop taking your medicines without talking to your doctor.
Other treatments may include:
As the illness gets worse, you will need to make changes in the home environment and get more help around the home.
Other important tips to follow:
How well you do depends on what caused the condition.
Cor pulmonale may lead to:
Call your doctor or nurse if you have shortness of breath or chest pain.
Avoiding behaviors that lead to chronic lung disease (especially cigarette smoking) may prevent the eventual development of cor pulmonale. Careful evaluation of childhood heart murmurs may prevent cor pulmonale caused by certain heart defects.
McGlothlin D, De Marco T. Cor pulmonale. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 56.
Massie BM. Heart failure: pathophysiology and diagnosis. In:Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: SaundersElsevier; 2011:chap 58.