Cor Pulmonale (Right-Sided Heart Failure)

What is cor pulmonale?

The definition of cor pulmonale (pulmonary heart) is when a lung issue causes your right ventricle (heart chamber) to get so big that your heart starts to fail. It’s a type of right-sided heart failure.

Normally, your right ventricle sends blood to your pulmonary artery to get oxygen from your lungs. But certain lung conditions cause high blood pressure in your pulmonary artery. That makes it harder for your right ventricle to get blood to your lungs.

Your right ventricle has to push against higher pressure in your pulmonary artery, where blood pressure is normally low. It’s like opening a car door when it’s windy outside. You have to push against the wind.

When your right ventricle has to keep working harder than normal, it gets larger and doesn’t work well.

Types of cor pulmonale

Types of cor pulmonale include:

• Acute cor pulmonale (short-term).
• Chronic cor pulmonale (long-term).

How common is cor pulmonale?

Cor pulmonale makes up an estimated 6% to 7% of heart disease cases in the United States.

What are the symptoms of cor pulmonale?

Cor pulmonale symptoms include:

• Shortness of breath.
• Bulging veins in your neck.
• Swelling in your legs or belly.
• Fatigue.
• Chest pain.
• Fainting episodes.

At first, you may not have cor pulmonale symptoms. They happen when you’ve had cor pulmonale for a while. Symptoms of cor pulmonale occur in addition to the symptoms of the lung condition that caused it.

What causes cor pulmonale?

Cor pulmonale causes include lung conditions that cause pulmonary hypertension, such as:

• Chronic obstructive pulmonary disease (COPD). This is the top cause of long-term cor pulmonale.
• Pulmonary embolism (blood clot).
• Trauma or surgery that removes lung tissue.
• Mechanical ventilation injury.
• Scleroderma.
• Cystic fibrosis.
• Neuromuscular disorders that affect breathing.
• Lung issues that block your veins.
• Pulmonary fibrosis (scarring).
• Obstructive sleep apnea.
• Kyphosis (curved spine).

What are the risk factors for cor pulmonale?

Risk factors for cor pulmonale include:

• Using tobacco products.
• Breathing polluted air.
• Having lung conditions that cause pulmonary hypertension.

What are the complications of cor pulmonale?

Complications of cor pulmonale may include:

• Abnormal heart rhythms.
• Right heart failure.
• Low oxygen levels (hypoxia).
• Fainting episodes.
• Kidney disease.
• Liver disease.
• Death.

How is cor pulmonale diagnosed?

A healthcare provider may hear abnormal sounds when they listen to your heart with a stethoscope. They’ll order tests to diagnose cor pulmonale.

What tests will be done to diagnose cor pulmonale?

Tests to diagnose cor pulmonale may include:

• Echocardiogram.
• Chest X-ray.
• Electrocardiogram (EKG).
• Nuclear medicine imaging.
• CT angiogram.
• Heart MRI.
• VQ scan.
• Right heart catheterization.

How is cor pulmonale treated?

Cor pulmonale treatment focuses on improving the lung issue that caused it.

The goal is to:

• Get more oxygen to your tissues if they need it.
• Help your right ventricle work better.
• Keep the blood vessels in your lungs from constricting too much so blood can get through more easily.

Quick treatment is important to prevent permanent damage to your heart.

Specific medicines or procedures used

Cor pulmonale treatments include:

• Oxygen therapy.
• Bronchodilators.
• Corticosteroids.
• Diuretics.
• Anticoagulants.
• Cardiac rehab.
• Blood clot removal (embolectomy).
• Pulmonary vasodilators.
• Lung or heart-lung transplant.

Complications/side effects of the treatment

Complications or side effects of treatments may include:

Can cor pulmonale be prevented?

You can prevent cor pulmonale by not getting the lung conditions that cause it. You can lower your risk of cor pulmonale by:

• Avoiding tobacco products and smoke.
• Avoiding air pollution.
• Avoiding things that cause pulmonary hypertension.
• Getting prompt treatment for lung conditions.

What can I expect if I have cor pulmonale?

Most people with cor pulmonale have a poor quality of life. Even with treatment, symptoms often come back.

How long cor pulmonale lasts

Cor pulmonale is usually a long-term condition. However, cor pulmonale from a mechanical ventilation injury or pulmonary embolism is a short-term condition.

Outlook for cor pulmonale

The condition that causes cor pulmonale determines the outlook for people who have it. Without management of the lung condition that caused it, the outlook is poor. For instance, only 30% of people who get cor pulmonale from COPD live another five years.

How do I take care of myself?

You can take care of yourself in these ways:

• Take medicines your provider prescribed.
• Attend all follow-up appointments.
• Stop using tobacco products.
• Exercise.
• Get shots (vaccines) that can prevent or ease the flu or other conditions that affect your lungs.

What can’t I eat/drink with cor pulmonale?

Your healthcare provider may limit how much salt and fluid you eat and drink.

When should I see my healthcare provider?

If you spent time in the hospital for cor pulmonale, you’ll need to follow up with a cardiologist and a pulmonologist (heart and lung specialists). They may want to see you in a week or two.

What questions should I ask my doctor?

Questions to ask your healthcare provider may include:

• What caused cor pulmonale in my case?
• What specific treatment do you recommend for me?
• What’s the outlook for my situation?
• How much and what kind of exercise would be right for me?
• Is there a support group for people in my situation?

A note from Cleveland Clinic

Cor pulmonale is an enlarged right ventricle in your heart that happens because of a lung condition. Having a medical condition that makes it hard to do everyday tasks can be frustrating. Ask family and friends for help if you need it. Your healthcare provider can explain your treatment options and which ones may work best for you. Don’t be afraid to ask questions if there’s anything you don’t understand about cor pulmonale.