Cor pulmonale is a condition that affects the right ventricle in the heart, altering its structure and proper functioning. It is caused by a respiratory system disorder. Pulmonary hypertension is a common underlying cause.

A person with cor pulmonale will have an enlarged right ventricle which cannot effectively pump blood. If a person does not seek treatment for the condition, the ventricle can be overworked and ultimately fail to pump blood at all.

A doctor may be able to prevent the condition by treating underlying conditions, such as pulmonary hypertension, before they lead to cor pulmonale or other life-threatening issues.

This article looks at what cor pulmonale is, the symptoms of the condition, along with how doctors diagnose and treat it.

A person undergoing a test to check their heart for cor palmonale.Share on Pinterest
Getty Images

Experts define cor pulmonale as changes to the function and structure of the right heart ventricle, the side that pumps blood to the lungs. It is caused by an overload of pressure. The condition can be acute or chronic.

Acute cor pulmonale

This condition develops suddenly and is most often caused by a massive pulmonary embolism. This occurs when part of a blood clot breaks away and travels to the lungs through the bloodstream. The clot can cause a blockage and damage the lungs. Doctors may be able to treat a small clot, but a large clot can stop blood from reaching the lungs and be fatal.

Chronic cor pulmonale

This condition develops over time. Chronic obstructive pulmonary disease (COPD) is the most common cause of chronic cor pulmonale. COPD is a chronic and progressively disabling disease that results in persistent respiratory symptoms. It is usually caused by significant exposure to noxious agents via breathing.

Researchers estimate that cor pulmonale accounts for 6–7% of adult heart disease in the United States. The incidence of the condition varies widely among different countries and depends on air pollution, the prevalence of cigarette smoking, and other risk factors for lung diseases.

Common symptoms of cor pulmonale include:

  • abnormally rapid breathing, especially while resting
  • fatigue
  • swelling in the ankles
  • worsening cough
  • shortness of breath
  • discomfort in the chest
  • coughing up blood
  • lightheadedness and dizziness
  • hoarseness

A doctor may diagnose cor pulmonale through medical testing and a physical examination. A doctor will examine a person for signs of fluid retention, an abnormal heartbeat, and protruding neck veins. A doctor may also use tests including:

A medical team with different specialties usually diagnoses and treats cor pulmonale. This may include a cardiologist, a pulmonologist who specializes in the respiratory system, an internist who specializes in conditions that affect the internal organs, a radiologist, and an intensivist who specializes in the care of critically ill patients.

A doctor or team of doctors will treat the underlying causes of cor pulmonale, such as pulmonary hypertension or COPD. Doctors will aim to improve a person’s oxygenation and right ventricular function. Treatment may include:

  • Prescription medication: Drugs can help decrease blood pressure and encourage oxygen flow to the lungs.
  • Blood thinners: These can help prevent blood clots.
  • Diuretics: These types of medications decrease fluid retention and lower levels of sodium in the blood.
  • Oxygen therapy: A treatment that involves breathing pure oxygen.
  • Surgery: People with advanced or severe cases of cor pulmonale may require surgery, such as a heart or lung transplant.

The outlook for cor pulmonale depends on the rate of progression, a person’s underlying conditions, and how the person and doctor manage them. A doctor will usually treat underlying conditions, such as pulmonary hypertension, to try to prevent or reduce the severity of cor pulmonale.

If a person is getting treatment for pulmonary hypertension, they should inform their doctor of any changes in their health so the doctor can adjust the treatment plan as needed.

If a person does not seek treatment for cor pulmonale, it can be life threatening. The overall 5-year survival rate for cor pulmonale with COPD is around 50%.

A person should focus on preventing underlying causes of cor pulmonale, such as pulmonary hypertension. A person can make various lifestyle decisions that could lower the risk of developing pulmonary hypertension, COPD, and similar conditions.

Those steps include:

  • stopping smoking
  • controlling certain medical conditions, such as blood-clotting disorders and kidney disease
  • avoiding lung irritants where possible, such as chemical fumes and dust
  • treating sleep apnea
  • maintaining a healthy weight

Learn more about reducing the impact of COPD here.

Cor pulmonale affects the functioning and structure of the right heart ventricle. It is caused by pressure brought on by conditions in the respiratory system, such as pulmonary hypertension.

Cor pulmonale can be acute and develop quickly, or chronic and develop gradually. Symptoms may include respiratory issues such as shortness of breath, as well as others such as fatigue and swelling in the ankles.

Treatments may include prescription medications, oxygen therapy, and surgery in severe cases. If a person does not seek treatment, the condition can be life threatening.