cardiovascular disorders
Cor Pulmonale
Key Points
Cor pulmonale is RV enlargement and eventually failure secondary to a lung disorder that causes pulmonary artery hypertension. Cor pulmonale itself is usually asymptomatic but common physical findings include a left parasternal systolic lift, a loud pulmonic component of S2, functional tricuspid and pulmonic regurgitation murmurs, and later, distended jugular veins, hepatomegaly, and lower-extremity edema. Diagnosis usually requires echocardiography or radionuclide imaging, and sometimes right heart catheterization. Early identification and treatment of the cause are important before cardiac structural changes become irreversible. Although patients may have significant peripheral edema, diuretics are not helpful and may be harmful; small decreases in preload often worsen cor pulmonale. 