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Cor Pulmonale

From Mediwikis

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

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

Presentation

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.

Investigations

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.