Cor pulmonale is defined as a failure of the structure and function of the right ventricle in the absence of left ventricular dysfunction. It is caused by an underlying primary disorder of the respiratory system. It has a generally chronic and slowly progressive course, although acute onset or worsening with life-threatening complications can occur.
- dominant R wave in lead V1 10
- defined as an R wave height > 7 mm or R/S > 1
- accompanied by dominant S waves in lead V6
- right axis deviation
- secondary repolarization abnormalities
- simultaneous involvement of the right precordium (V1-4) and inferior limb leads (II, III, aVF)
- depressed ST segments with T wave inversion
- right atrial enlargement
- chronic obstructive pulmonary disease
- pulmonary manifestations of cystic fibrosis
- interstitial lung disease
- massive pulmonary emboli: for acute cor pulmonale
- acute respiratory distress syndrome: for acute cor pulmonale
- central pulmonary artery enlargement 7
- changes consistent with underlying pulmonary disease as outlined above
May show dilatation of the left ventricular cavity or thickening of the right ventricular free wall 6.
Treatment and prognosis
Cor pulmonale generally carries a poor prognosis. Long-term oxygen therapy is often considered the main treatment option.
History and etymology
From the Latin, cor: 'heart', and pulmonale, 'relating to the lungs', ultimately from the Latin pulmo meaning 'lung'. Therefore 'heart secondary to / relating to the lungs'.
- 1. Pattynama PM, Willems LN, Smit AH et-al. Early diagnosis of cor pulmonale with MR imaging of the right ventricle. Radiology. 1992;182 (2): 375-9. Pubmed citation
- 2. S. Cor pulmonale. Treatment implications of right versus left ventricular impairment. Postgrad Med. 1992;91 (6): 227-36. Pubmed citation
- 3. Vandiviere HM. Pulmonary hypertension and cor pulmonale. South. Med. J. 1993;86 (10): 2S7-10. Pubmed citation
- 4. Matthay RA, Berger HJ. Cardiovascular function in cor pulmonale. Clin. Chest Med. 1983;4 (2): 269-95. Pubmed citation
- 5. Saito H, Dambara T, Aiba M et-al. Evaluation of cor pulmonale on a modified short-axis section of the heart by magnetic resonance imaging. Am. Rev. Respir. Dis. 1992;146 (6): 1576-81. doi:10.1164/ajrccm/146.6.1576 - Pubmed citation
- 6. Wiedemann HP, Matthay RA. Cor pulmonale in chronic obstructive pulmonary disease. Circulatory pathophysiology and management. Clin. Chest Med. 1990;11 (3): 523-45. Pubmed citation
- 7. Webb W. Thoracic Imaging. Lippincott Williams and Wilkins. ISBN:1451110898. Read it at Google Books - Find it at Amazon
- 8. Gopalan D. Right heart on multidetector CT. The British journal of radiology. 84 Spec No 3: S306-23. doi:10.1259/bjr/59278996 - Pubmed
- 9. Kang DK, Thilo C, Schoepf UJ, Barraza JM, Nance JW, Bastarrika G, Abro JA, Ravenel JG, Costello P, Goldhaber SZ. CT signs of right ventricular dysfunction: prognostic role in acute pulmonary embolism. JACC. Cardiovascular imaging. 4 (8): 841-9. doi:10.1016/j.jcmg.2011.04.013 - Pubmed
- 10. Harrigan RA, Jones K. ABC of clinical electrocardiography. Conditions affecting the right side of the heart. (2002) BMJ (Clinical research ed.). 324 (7347): 1201-4. Pubmed