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
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.
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:
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:
Calcium channel blockers
Prostacyclin or similar medications
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:
Blood thinners to reduce the risk of blood clots
Oxygen, in some cases
A lung or heart-lung transplant, if medication does not work
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:
Avoid strenuous activities and heavy lifting
Avoid traveling to high altitudes
Get yearly flu and pneumonia vaccines
Talk to your doctor before becoming pregnant
How well you do depends on what caused the condition.
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.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.