What is the definition of Cor Pulmonale?

Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the arteries of the lung and right ventricle of the heart can lead to cor pulmonale.

What are the alternative names for Cor Pulmonale?

Right-sided heart failure; Pulmonary heart disease

What are the causes for Cor Pulmonale?

High blood pressure in the arteries of the lungs is called pulmonary hypertension. It is the most common cause of cor pulmonale.

In people who have pulmonary hypertension, changes in the small blood vessels inside the lungs can lead to increased blood pressure in the right side of the heart. This makes it harder for the heart to pump blood to the lungs. If this high pressure continues, it puts a strain on the right side of the heart. That strain can cause cor pulmonale.

Lung conditions that cause a low blood oxygen level in the blood over a long time can also lead to cor pulmonale. Some of these are:

  • Autoimmune diseases that damage the lungs, such as scleroderma
  • Chronic obstructive pulmonary disease (COPD)
  • Chronic blood clots in the lungs
  • Cystic fibrosis (CF)
  • Severe bronchiectasis 
  • Scarring of the lung tissue (interstitial lung disease)
  • Severe curving of the upper part of the spine (kyphoscoliosis)
  • Obstructive sleep apnea, which causes stops in breathing because of airway inflammation
  • Idiopathic (no specific cause) tightening (constriction) of the blood vessels of the lungs

What are the symptoms for Cor Pulmonale?

Shortness of breath or lightheadedness during activity is often the first symptom of cor pulmonale. You may also have a fast heartbeat and feel like your heart is pounding.

Over time, symptoms occur with lighter activity or even while you are at rest. Symptoms you may have are:

  • Fainting spells during activity
  • Chest discomfort, usually in the front of the chest
  • Chest pain
  • Swelling of the feet or ankles
  • Symptoms of lung disorders, such as wheezing or coughing or phlegm production
  • Bluish lips and fingers (cyanosis)

What are the current treatments for Cor Pulmonale?

The goal of treatment is to control symptoms. It is important to treat medical problems that cause pulmonary hypertension, because they can lead to cor pulmonale.

Many treatment options are available. In general, the cause of your cor pulmonale will determine which treatment you receive.

If your provider prescribes medicines, you may take them by mouth (oral), receive them through a vein (intravenous or IV), or breathe them in (inhaled). 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 first talking to your provider.

Other treatments may include:

  • Blood thinners to reduce the risk of blood clots
  • Medicines to manage heart failure symptoms
  • Oxygen therapy at home
  • A lung or heart-lung transplant, if medicine does not work

Important tips to follow:

  • Avoid strenuous activities and heavy lifting.
  • Avoid traveling to high altitudes.
  • Get a yearly flu vaccine, as well as other vaccines, such as the pneumonia vaccine.
  • If you smoke, stop.
  • Limit how much salt you eat. Your provider also may ask you to limit how much fluid you drink during the day.
  • Use oxygen if your provider prescribes it.
  • Women should not get pregnant.

What is the outlook (prognosis) for Cor Pulmonale?

How well you do depends on the cause of your cor pulmonale.

As your illness gets worse, you will need to make changes to your home so that you can manage as well as possible. You will also need help around your house.

What are the possible complications for Cor Pulmonale?

Cor pulmonale may lead to:

  • Life-threatening shortness of breath
  • Severe fluid buildup in your body
  • Shock
  • Death

When should I contact a medical professional for Cor Pulmonale?

Call your provider if you have shortness of breath or chest pain.

How do I prevent Cor Pulmonale?

Do not smoke. Smoking causes lung disease, which can lead to cor pulmonale.

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REFERENCES

Barnett CF, De Marco T. Pulmonary hypertension due to lung disease. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 59.

Bhatt SP, Dransfield MT. Chronic lung diseases and cardiovascular disease. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 86.

Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Other
  • Participants: 48
  • Start Date: January 9, 2020
Unmasking Right Ventricular and Pulmonary Derangements With Exercise and Oxygen in Early Stage Cardiopulmonary Diseases
Clinical Trial
  • Status: Not yet recruiting
  • Phase: Phase 1
  • Intervention Type: Drug
  • Participants: 45
  • Start Date: December 2021
A Randomized Trial of Chlorhexidine Mouthwash and Oral Nitrate in Adults With Pulmonary Hypertension