Cor pulmonale is a condition that changes the way the right ventricle of the heart works and even sometimes its shape or structure because of pulmonary hypertension. Pulmonary hypertension is higher pressure in the pulmonary arteries, which makes it very difficult for the right ventricle to pump blood to the lungs. When this high-pressure situation exists, the right ventricle can gradually enlarge, get damaged and/or become exhausted in the process of trying to perform its job. This can lead to heart failure.
The causes of cor pulmonale are intricately linked to causes of pulmonary hypertension. Numerous things can create increased pressure in the pulmonary arteries, which include structural defects, conditions like cystic fibrosis, black lung disease, or chronic obstructive pulmonary disease (COPD). Of these, COPD is usually the leading cause of cor pulmonale and people most at risk for COPD are smokers.
In early stages of this condition, people may not have many symptoms of right heart failure though they may have symptoms of the condition causing it. These could include shortness of breath, pressure on the chest, and coughing. As cor pulmonale advances, edema (swelling) is usually noted especially in the extremities and particularly in the feet and the legs.
The neck veins can also look more prominent in those who suffer from this disease. Poor oxygenation to the rest of the body may give the skin a bluish (cyanotic) tinge, especially at the nail beds. Heart rhythm is typically abnormal and a pronounced murmur is usually perceptible upon examination.
People will usually see a cardiologist if cor pulmonale is suspected, and the cardiologist can perform several tests to confirm it. These can include physical examination, echocardiogram, and chest x-ray. Doctors may also order scans of the lungs or cardiac catheterization, to determine extent of pulmonary hypertension and presence of structural damage in the right ventricle.
Various treatments exist for this condition, but it can depend on what is causing it. It may not be possible to completely rid people of the symptoms of COPD for instance, and cystic fibrosis is incurable. Nevertheless, some treatments can help improve right-sided heart function. These include using calcium channel blockers, and several inhaled medications. If there is significant damage to the heart or to the lungs, surgery may be considered to repair heart structure defects, or potentially to do a heart/lung transplant.
Without treatment, cor pulmonale is often eventually fatal, and at present the treatments won’t cure it, in most cases, though they can prolong life. Usually the condition remains chronic. It is a challenging illness that requires careful monitoring and attention to treatment when it is discovered.
