Cor pulmonale is failure of the right side of the heart caused by prolonged high blood pressure in the pulmonary artery and right ventricle of the heart.

Right-sided heart failure - cor pulmonale

Normally, the left side of the heart produces a higher blood pressure in order to pump blood to the body. The right side pumps blood through the lungs under much lower pressure.

Any condition that leads to prolonged high blood pressure in the arteries or veins of the lungs (called pulmonary hypertension) puts a strain on the right side of the heart. When this right ventricle fails or is unable to properly pump against these abnormally high pressures, this is called cor pulmonale.

Almost any chronic lung disease or condition causing prolonged low blood oxygen can lead to cor pulmonale. A few of these causes include:

• Chronic obstructive pulmonary disease (COPD)
• Obstructive sleep apnea
• Central sleep apnea
• Mountain sickness
• Cystic fibrosis
• Primary pulmonary hypertension
• Pneumoconiosis
• Kyphoscoliosis
• Interstitial lung disease
• Chronic thromboembolic pulmonary disease
• Pulmonary vascular disease
• Pulmonary hypertension

• Shortness of breath
• Symptoms of underlying disorders (wheezing, coughing)
• Swelling of the feet or ankles
• Exercise intolerance
• Chest discomfort

• Bluish color to the skin (cyanosis)
• Distension of the neck veins indicating high right-heart pressures
• Abnormal fluid collection in the abdomen, enlargement of the liver
• Swelling of the ankles
• Abnormal heart sounds

The following tests may help diagnose cor pulmonale:

• Echocardiogram (heart ultrasound)
• Chest x-ray
• CAT scan of the chest
• Pulmonary function tests
• Swan-Ganz catheterization
• V/Q scan
• Measurement of blood oxygen by arterial blood gas (ABG)
• Lung biopsy (rarely performed)
• Blood antibody tests
• Blood test for brain natriuretic peptide (BNP)