Cor pulmonale

Question 1

Definition of cor pulmonale

Answer 1

Altered structure (hypertrophy/dilation) and failure of the right ventricle secondary to pulmonary hypertension due to lung disease

Question 2

Causes of cor pulmonale

Answer 2

• Acute:
  
  • PE
  • ARDS
• Chronic:
  
  • COPD

Question 3

Symptoms of cor pulmonale

Answer 3

• Dyspnoea
• Fatigue
• Cough

Question 4

Signs of cor pulmonale

Answer 4

• Split S2 with loud P2
• Raised JVP
• Tender hepatomegaly
• Ascites
• Peripheral oedema
• RV/parasternal heave

Question 5

Investigations for cor pulmonale

Answer 5

• ECG - RAD, prominent R in V1
• Imaging:
  
  • CXR - right ventricular enlargement, prominent pulmonary arteries, signs of COPD
  • Doppler echo
  • MRI
• Cardiac catheterisation

Question 6

Management of cor pulmonale

Answer 6

• Treat underlying cause
• Other drugs:
  
  • Diuretics
  • CCB