Cor Pulmonale

Cor Pulmonale

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Pathology: Rightheart Failure due to Chronic Pulmonary Hypertension

The pathology of rightheart failure due to chronic pulmonary hypertension is generally associated with any cause of pulmonary hypertension such as acute pulmonary embolism, primary pulmonary hypertension, chronic pulmonary embolism, parasitic infection, COPD, asthma, pulmonary fibrosis, bronchiectasis, motor neurone disease, myasthenia gravis, kyphosis, scoliosis, and OSA.

Symptoms and Signs

Patients who experience rightheart failure due to chronic pulmonary hypertension typically exhibit symptoms such as dyspnoea, fatigue, anorexia, and weight loss, as well as signs including peripheral oedema, raised JVP, right ventricular heave, cyanosis, tricuspid regurgitation, hepatomegaly, and cyanosis.


  • ECG: Right ventricular hypertrophy and right axis deviation, P pulmonale.
  • Chest X-Ray: Right atrial enlargement, cardiomegaly.
  • FBC: Polycythaemia.
  • ECHO: Right ventricular dysfunction, tricuspid regurgitation and estimation of rightsided pressures.


The treatment of a rightheart failure due to chronic pulmonary hypertension is geared towards addressing the underlying cause as well as providing oxygen if hypoxic, diuretics, and heart-lung transplantation.

Complications and Prognosis

Complications associated with rightheart failure due to chronic pulmonary hypertension include arrhythmia and liver failure, while the prognosis for this condition is generally poor, with a 50% 5 year mortality rate.

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