cor pulmonale

The right ventricle normally pumps against the lungs, which usually offer little resistance — like blowing through a wide-open straw. In cor pulmonale, lung disease narrows or stiffens that path, so the right ventricle must strain against high pressure, and over time it tires and fails. The name is Latin for ‘pulmonary heart.’

Cor pulmonale is right ventricular enlargement and ultimately failure caused by disease of the lungs or the pulmonary circulation — not by a problem starting in the left heart. The common thread is pulmonary hypertension. Causes include chronic obstructive pulmonary disease, interstitial lung disease, sleep-disordered breathing, and chronic pulmonary embolism. The chronically overloaded right ventricle hypertrophies and dilates, and signs of systemic venous congestion appear: leg swelling, raised neck veins, and an enlarged, sometimes tender liver.

Because the root cause lies in the lungs, treatment centers on the underlying lung disease — for example, oxygen therapy, treating COPD, or addressing sleep apnea — alongside diuretics to relieve congestion. Acute cor pulmonale, by contrast, describes sudden right heart strain from a large pulmonary embolism, a separate emergency from this chronic picture.