11- Cor Pulmonale

KYJ11- Cor Pulmonale
In this "knowing your jargon" series, we have looked at heart failure that affects the Left heart (LVF) and it's subcategories of systolic and Diastolic failure.

This episode of KYJ we look at Right heart failure also known by its Latin name Cor Pulmonale (pulmonary cardiac (failure)).

In Right heart failure, the right ventricle fails to pump volume into the pulmonary vascular network.  The most common cause is high blood pressure inside lungs (pulmonary hypertension), secondary to lung diseases both acute (pulmonary embolism) and chronic lung diseases eg COPD.

In these restrictive lung diseases, there exists a reduction in lung vessels, meaning the right heart must push harder against the resistance of fewer blood vessels.  This causes the right heart to fail.
Another common contributing factor is obstructive sleep apnoea (OSA).

With inability to clear blood returning to the right heart, venous congestion builds up giving rise to a characteristic set of symptoms.
Jugular venous distension
Ankle oedema ( sometimes pitting)
Ascites .
Breathlessness on exertion and lethargy.

As the cause of Cor Pulmonale is always respiratory, treatment focuses on managing the underlying pathology. Eg sleep
Apnoea is managed with CPAP.
PE managed with thrombolysis or heparin/warfarin.

Right heart failure often leads to
Left failure and together these conditions are called Congestive Heart Failure (CHF or CCF).

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