From the Guidelines
Cor pulmonale is a condition characterized by right heart failure due to lung disease, where the right ventricle of the heart enlarges and fails because of increased pressure in the pulmonary circulation caused by underlying respiratory disorders. This condition is often a result of chronic lung diseases such as chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and pulmonary vascular disease (PVD) 1. The development of cor pulmonale is attributed to the increased resistance in the pulmonary blood vessels, which forces the right ventricle to work harder to pump blood through the lungs, eventually leading to right heart failure.
Some key points to consider in the development of cor pulmonale include:
- Increased pulmonary vascular resistance due to vascular destruction or obstruction, and hypoxic vasoconstriction 1
- Right ventricular hypertrophy and eventual failure as the disease progresses 1
- Symptoms such as shortness of breath, fatigue, chest pain, swelling in the legs and abdomen, and decreased exercise tolerance
- Treatment focuses on managing the underlying lung condition, with medications such as bronchodilators, oxygen therapy, and diuretics, as well as vasodilators to reduce pulmonary pressure in severe cases.
It is essential to note that cor pulmonale can be prevented or delayed by managing the underlying lung disease and reducing risk factors such as smoking and inactivity 1. Early detection and treatment of cor pulmonale can significantly improve morbidity, mortality, and quality of life for patients with this condition.
From the Research
Definition of Cor Pulmonale
- Cor pulmonale is defined as right ventricular hypertrophy and/or dilation caused by pulmonary hypertension (PH) due to diseases affecting the lung function and structure 2.
Causes of Cor Pulmonale
- The leading cause of cor pulmonale is chronic obstructive pulmonary disease (COPD) 2.
- In COPD, cor pulmonale is generally known to occur due to loss of vascular bed and chronic hypoxic pulmonary vasoconstriction (HPV) due to alveolar wall destruction 2.
Diagnosis of Cor Pulmonale
- The definition of PH was revised from a mean pulmonary arterial pressure (mPAP) >25 mmHg to an mPAP >20 mmHg, which might expedite the detection of cor pulmonale 2.
Treatment of Cor Pulmonale
- The only treatment for cor pulmonale for the past 3 decades has been to maintain the lung function and oxygen saturation 2.
- There is no evidence supporting the treatment of COPD patients with PH using drugs approved for PAH, but such drugs may be effective in the treatment of a selected group of COPD patients whose disease includes PAH-like vascular components 2.