Cor pulmonale
Right-sided heart failure; Pulmonary heart diseaseCor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the pulmonary arteries of the lung and right ventricle of the heart can lead to cor pulmonale.
Causes
High blood pressure in the pulmonary arteries of the lungs is called pulmonary hypertension. It is the most common cause of cor pulmonale.
High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
Read Article Now Book Mark ArticlePulmonary hypertension
Pulmonary hypertension is high blood pressure in the pulmonary arteries of the lungs. It makes the right side of the heart work harder than normal....
Read Article Now Book Mark ArticleIn 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:
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Autoimmune diseases that damage the lungs, such as scleroderma
Autoimmune diseases
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...
Read Article Now Book Mark ArticleScleroderma
Scleroderma is a disease that involves the buildup of fibrous tissue in the skin and elsewhere in the body. It also damages the cells that line the ...
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Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe. There are two main forms of COPD:Chroni...
Read Article Now Book Mark Article - Chronic blood clots in the lungs
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Cystic fibrosis (CF)
Cystic fibrosis
Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of th...
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Severe bronchiectasis
Severe bronchiectasis
Bronchiectasis is a disease in which the large airways in the lungs are damaged. This causes the airways to become permanently wider. Bronchiectasis...
Read Article Now Book Mark Article - Scarring of the lung tissue (interstitial lung disease)
Interstitial lung disease
Interstitial lung disease (ILD) is a group of lung disorders in which the lung tissues become inflamed and then damaged.
Read Article Now Book Mark Article - Severe curving of the upper part of the spine (kyphoscoliosis)
Kyphoscoliosis
Scoliosis is an abnormal curving of the spine. Your spine is your backbone. It runs straight down your back. Everyone's spine naturally curves a b...
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Obstructive sleep apnea, which causes stops in breathing during sleep
Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a problem in which your breathing pauses during sleep. This occurs because of narrowed or blocked airways.
Read Article Now Book Mark Article - Idiopathic (no specific cause) tightening (constriction) of the blood vessels of the lungs, also called primary pulmonary hypertension
- Severe left-sided heart failure
Symptoms
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
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
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Bluish lips and fingers (cyanosis)
Bluish lips and fingers
A bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.
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Exams and Tests
Your health care provider will perform a physical exam and ask about your symptoms. The exam may find:
- Fluid buildup in your belly
- Abnormal heart sounds
- Bluish skin
- Liver swelling
- Swelling of the neck veins, which is a sign of high pressure in the right side of the heart
- Ankle swelling
These tests may help diagnose cor pulmonale as well as its cause:
- Blood antibody tests
- Blood test to check for a substance called brain natriuretic peptide (BNP)
Brain natriuretic peptide
Brain natriuretic peptide (BNP) test is a blood test that measures levels of the protein BNP that is made by your heart and blood vessels. BNP level...
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT scan of the chest, with or without an injection of a contrast fluid (dye)
CT scan of the chest
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
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Electrocardiogram (ECG)
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Lung biopsy (rarely done)
Lung biopsy
An open lung biopsy is surgery to remove a small piece of tissue from the lung. The sample is then examined for cancer, infection, or lung disease....
Read Article Now Book Mark Article - Measurement of blood oxygen by checking arterial blood gas (ABG)
Arterial blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Pulmonary (lung) function tests
Pulmonary (lung) function tests
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
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Right heart catheterization
Right heart catheterization
Swan-Ganz catheterization (also called right heart catheterization or pulmonary artery catheterization) is the passing of a thin tube (catheter) into...
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Ventilation and perfusion scan of the lungs (V/Q scan)
Ventilation and perfusion scan of the l...
A pulmonary ventilation/perfusion scan involves two nuclear scan tests to measure breathing (ventilation) and circulation (perfusion) in all areas of...
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Treatment
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.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
Read Article Now Book Mark ArticleOther treatments may include:
- Blood thinners to reduce the risk of blood clots
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Medicines to manage heart failure symptoms
Medicines to manage heart failure sympt...
Most people who have heart failure need to take medicines. Some of these medicines are used to treat your symptoms. Others may help prevent your he...
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Oxygen therapy at home (as in most cases of cor pulmonale, oxygen is low)
Oxygen therapy at home
Choking is when someone cannot breathe because food, a toy, or other object is blocking the throat or windpipe (airway). This article discusses cho...
Read Article Now Book Mark Article - 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 pneumococcal (pneumonia) vaccine, and the COVID-19 vaccine.
Flu vaccine
All content below is taken in its entirety from the CDC Inactivated Influenza Vaccine Information Statement (VIS) www. cdc. gov/vaccines/hcp/vis/vis-...
Read Article Now Book Mark ArticlePneumococcal (pneumonia) vaccine
Content below is taken in its entirety from the CDC Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis/vis-statements/pcv. html
Read Article Now Book Mark ArticleCOVID-19 vaccine
COVID-19 vaccines are used to prepare the body's immune system to protect against COVID-19. Everyone ages 6 months and older should get a 2024-2025 C...
Read Article Now Book Mark Article - If you smoke, stop.
Smoke, stop
There are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...
Read Article Now Book Mark Article - 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.
Outlook (Prognosis)
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.
Possible Complications
Cor pulmonale may lead to:
- Life-threatening shortness of breath
- Severe fluid buildup in your body
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Shock
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
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When to Contact a Medical Professional
Contact your provider if you have shortness of breath or chest pain.
Prevention
Do not smoke. Smoking causes lung disease, which can lead to cor pulmonale.
References
Lammi MR, Mathai SC. Pulmonary hypertension: general approach. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 83.
Maron B. Pulmonary hypertension. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 88.
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Sarcoid, stage IV - chest x-ray - illustration
This film shows advanced sarcoid, scarring of the lungs (the light streaking), and cavity formation (the dark areas in the upper right side of the picture).
Sarcoid, stage IV - chest x-ray
illustration
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Acute vs. chronic conditions - illustration
Acute conditions are severe and sudden in onset. This could describe anything from a broken bone to an asthma attack. A chronic condition, by contrast is a long-developing syndrome, such as osteoporosis or asthma. Note that osteoporosis, a chronic condition, may cause a broken bone, an acute condition. An acute asthma attack occurs in the midst of the chronic disease of asthma. Acute conditions, such as a first asthma attack, may lead to a chronic syndrome if untreated.
Acute vs. chronic conditions
illustration
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Cor pulmonale - illustration
Chronically low blood levels of oxygen may lead to pulmonary hypertension (high blood pressure in the lungs), and possibly to cor pulmonale. Cor pulmonale is also called right-sided heart failure, and is characterized by enlargement of the right ventricle. Treatment targets the underlying illness and may include supplemental oxygen, a low-salt diet or calcium channel blockers.
Cor pulmonale
illustration
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Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Sarcoid, stage IV - chest x-ray - illustration
This film shows advanced sarcoid, scarring of the lungs (the light streaking), and cavity formation (the dark areas in the upper right side of the picture).
Sarcoid, stage IV - chest x-ray
illustration
-
Acute vs. chronic conditions - illustration
Acute conditions are severe and sudden in onset. This could describe anything from a broken bone to an asthma attack. A chronic condition, by contrast is a long-developing syndrome, such as osteoporosis or asthma. Note that osteoporosis, a chronic condition, may cause a broken bone, an acute condition. An acute asthma attack occurs in the midst of the chronic disease of asthma. Acute conditions, such as a first asthma attack, may lead to a chronic syndrome if untreated.
Acute vs. chronic conditions
illustration
-
Cor pulmonale - illustration
Chronically low blood levels of oxygen may lead to pulmonary hypertension (high blood pressure in the lungs), and possibly to cor pulmonale. Cor pulmonale is also called right-sided heart failure, and is characterized by enlargement of the right ventricle. Treatment targets the underlying illness and may include supplemental oxygen, a low-salt diet or calcium channel blockers.
Cor pulmonale
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 5/3/2024
Reviewed By: Allen J. Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant Professor, Rutgers New Jersey Medical School, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.