Cor pulmonale is one of the complications of emphysema and is caused by an increase in blood pressure in the pulmonary artery, the vessel that carries blood from the heart to the lungs. This leads to enlargement and subsequent failure of the right side of the heart.
Alternative Names
Right-sided heart failure
Causes
Under normal circumstances, the left side of the heart is responsible for pumping blood to the entire body, which requires a higher pressure. The right side of the heart assumes the role of pumping blood through the lungs, which requires a much lower pressure.
Any condition that leads to pulmonary hypertension, or high blood pressure within the blood vessels of the lungs, can put a strain on the right side of the heart. When the right side of the heart fails or is unable to work against the abnormally high pressures within the lungs, this is called cor pulmonale.
Many chronic lung diseases can lead to cor pulmonale. The following lists a number of these causes:
- Chronic obstructive pulmonary disease (COPD)
- Obstructive sleep apnea
- Central sleep apnea
- Cystic fibrosis
- Pulmonary hypertension
- Black lung disease
- Interstitial lung disease
- Chronic thromboembolic pulmonary disease
- Pulmonary hypertension
Symptoms
Symptoms of cor pulmonale are normally related to the underlying lung disease. They include:
- Dyspnea
- Wheezing and coughing (symptoms of underlying lung disease)
- Swelling of the feet or ankles
- Inability to tolerate exercise
- Chest discomfort
- Cyanosis
- Pronounced neck veins (indicates an increase in right heart pressures
Visit About.com's Symptom Checker for more information about symptoms or cor pulmonale or other conditions.
Diagnostic Tests
The following includes a list of tests that may used to help diagnose cor pulmonale:
- Echocardiogram
- Chest x-ray
- CAT scan of the chest
- Pulmonary function tests
- Pulmonary artery catheterization
- Ventilation/Perfusion Scan
- Arterial Blood Gases
- Blood antibody tests
- B-type natriuretic peptide blood test (BNP)
Treatment
Treatment is aimed at the underlying illness and may include the following:
- Oxygen therapy may be used to increase the level of oxygen in the bloodstream.
- Calcium channel blockers
- Prostacyclin
- Sildenafil
- Anticoagulants
- Heart or lung transplant (in very advanced cases)
Prevention
Because many cases of cor pulmonale are caused by COPD, quitting smoking can help slow the progression of COPD and may prevent the development of cor pulmonale.
If cor pulmonale is caused by a heart defect, then careful assessment of childhood heart murmurs may also help prevent it.
Prognosis
The prognosis for cor pulmonale depends on the underlying cause of the condition. Treatment with oxygen, medications or surgery can result in improved symptoms, more energy and possibly a longer survival rate.
Possible Complications
Pulmonary hypertension and cor pulmonale can lead to severe fluid retention that can cause life-threatening shortness of breath, shock and even death.
When to Contact Your Health-are Provider
Call your doctor immediately if you experience shortness of breath or chest pain that is unrelieved by rest.
For more information about cor pulmonale, contact your healthcare provider.
Source:
A.D.A.M. http://adam.about.com/encyclopedia/infectiousdiseases/Cor-pulmonale.htm
