Cor pulmonale Health Article

Definition

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.

Alternative Names

Right-sided heart failure

Causes, incidence, and risk factors

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.

Any condition that leads to prolonged high blood pressure in the arteries of the lungs (called pulmonary hypertension) puts a strain on the right side of the heart. When the right ventricle is unable to properly pump against these abnormally high pressures, it is called cor pulmonale.

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

• Central sleep apnea
• Chronic obstructive pulmonary disease (COPD)
• Chronic thromboembolic pulmonary disease
• Cystic fibrosis
• Interstitial lung disease
• Kyphoscoliosis
• Obstructive sleep apnea
• Pneumoconiosis
• Primary pulmonary hypertension
• Pulmonary vascular disease
• Secondary pulmonary hypertension

Symptoms

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

Signs and tests

• Abnormal fluid collection in the abdomen
• Abnormal heart sounds
• Bluish color to the skin (cyanosis)
• Enlargement of the liver
• Swelling (distension) of the neck veins, indicating high right-heart pressures
• Swelling of the ankles

The following tests may help diagnose cor pulmonale:

• Blood antibody tests
• Blood test for brain natriuretic peptide (BNP)
• Chest x-ray
• CT scan of the chest
• Echocardiogram
• Lung biopsy (rarely performed)
• Measurement of blood oxygen by arterial blood gas (ABG)
• Pulmonary function tests
• Right heart catheterization
• Ventilation and perfusion scan of the lungs (V/Q scan)