Cor pulmonale

Alternative names

Right-sided heart failure - cor pulmonale

Definition

Failure of the right side of the heart caused by prolonged high blood pressure in the pulmonary artery and right ventricle of the heart.

Causes, incidence, and risk factors

Normally, the left side of the heart produces a higher level of blood pressure in order to pump blood to the body; the right side pumps blood through the lungs under much lower pressure. Any condition that leads to prolonged high blood pressure in the arteries or veins of the lungs (called pulmonary hypertension) will be poorly tolerated by the right ventricle of the heart. When this right ventricle fails or is unable to properly pump against these abnormally high pressures, this is called cor pulmonale.

Almost any chronic lung disease or condition causing prolonged low blood oxygen can lead to cor pulmonale. A few of these causes include:

• Chronic obstructive pulmonary disease (COPD)
  
• Obstructive sleep apnea
  
• Central sleep apnea
  
• Chronicmountain sickness
  
• Cystic fibrosis
  
• Primary pulmonary hypertension
  
• Pneumoconiosis
  
• Kyphoscoliosislung disease
  
• Diffuse pulmonary interstitial fibrosis
  
• Chronic thromboembolic pulmonary disease
  
• Pulmonary vascular disease; pulmonary hypertension
  

Symptoms

• Shortness of breath
  
• Symptoms of underlying disorders (wheezing, coughing)
  
• Swelling of the feet or ankles
  
• Exercise intolerance
  
• Chest discomfort
  

Signs and tests

• Bluish color to the skin (cyanosis)
  
• Distension of the neck veins indicating high right-heart pressures
  
• Abnormal fluid collection in the abdomen, enlargement of the liver
  
• Edema (swelling) of the ankles
  
• Abnormal heart sounds
  

Some tests that may help diagnose cor pulmonale include: