Cor Pulmonale: An Overview

Marie M. Budev; Alejandro C. Arroliga; Herbert P. Wiedemann; Richard A. Matthay

doi:10.1055/s-2003-41105

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2003; 24(3): 233-244
DOI: 10.1055/s-2003-41105

Cor Pulmonale: An Overview

Marie M. Budev¹ , Alejandro C. Arroliga¹ , Herbert P. Wiedemann¹ , Richard A. Matthay²

¹The Cleveland Clinic Foundation, Department of Pulmonary and Critical Care Medicine, Cleveland, Ohio
²Pulmonary and Critical Care Section, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut

Abstract

ABSTRACT

Chronic cor pulmonale involves the enlargement of the right ventricle as a result of pulmonary hypertension due to pulmonary disorders involving the lung parenchyma, bellows function, or ventilatory drive. The right ventricular hypertrophy that occurs in chronic cor pulmonale is a direct result of chronic hypoxic pulmonary vasoconstriction and subsequent pulmonary artery hypertension, leading to increased right ventricular work and stress. We discuss methods by which hypoxic vasoconstriction and reduction in the pulmonary vascular bed lead to the development of pulmonary artery hypertension. This article reviews the interaction of the pulmonary vasculature and right ventricle in the nondiseased state as well as during disease exacerbations. Ventricular dependence and its contribution to the pathophysiology of right ventricular failure are also reviewed. In addition, we provide an overview of specific disease states that can result in the development of chronic cor pulmonale including chronic obstructive pulmonary disease (COPD), interstitial lung disease, sleep apnea, alveolar hypoventilation disorders, and primary pulmonary hypertension. We also review the current diagnostic studies used to evaluate and study cor pulmonale.

KEYWORDS

Chronic cor pulmonale - right ventricular failure - pulmonary heart disease - interventricular dependence

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References

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