cor pulmonale

Cor pulmonale is Latin for pulmonary heart, and the name captures the idea exactly: a heart problem caused by the lungs. Specifically, it is enlargement and eventual failure of the right ventricle, the chamber that pumps blood into the lungs, brought on by a long-standing rise in pulmonary blood pressure from chronic lung disease.

The mechanism is one of overwork. When the lungs become diseased, low oxygen and damaged or constricted vessels raise the resistance the right ventricle must pump against. Like any muscle facing a heavier load over years, the right ventricle first thickens, then stretches and weakens, and finally struggles to keep up. The result can be swollen legs, a distended neck vein, an enlarged liver, and worsening breathlessness.

By convention, cor pulmonale refers to right heart failure arising from disease of the lungs or pulmonary vessels, not from left-sided heart disease, even though left heart failure can also overload the right side. Chronic obstructive pulmonary disease is the most common cause worldwide. Treatment centres on the underlying lung condition and on relieving low oxygen, which is the main driver of the raised pressure.