Cor Pulmonale is right heart failure caused by chronic pulmonary arterial hypertension. In cor pulmonale, mean arterial pressure is normally >20mm Hg. This can develop into complete right heart failure if pressure is >40mm Hg.
Causes of cor pulmonale can be classified as such:
- Lung Disease, such as severe asthma, COPD, bronchiectasis or pulmonary fibrosis
- Pulmonary vascular disease: PE, pulmonary vasculitis, sickle-cell disease
- Thoracic cage abnormality: kyphosis, scoliosis
- Neuromuscular disorders: Myasthenia gravis, polio
Clinical features include dyspnoea, fatigue and syncope. However, symptoms are largely non-specific in early-stage disease. Signs of late stage disease include haemoptysis, hoarseness, anorexia and jaundice.
The underlying cause of cor pulmonale should be identified. Therefore, tests to detect alpha-1 antitrypsin disease, thrombophilia screen and autoantibody screen may be useful. Standard investigations include lung function tests and chest X ray. ECG may indicate p-pulmonale, right axis deviation and right ventricular hypertrophy.