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Cor Pulmonale

Cor Pulmonale
Cor pulmonale is right ventricular hypertrophy and dilation associ
ated with pulmonary hypertension. Increased resistance to flow
into the pulmonary arteries or arterioles results in pressure over
load on the right ventricle with subsequent compensatory hyper
trophy. In addition to increased resistance within the pulmonary
vessels, hypoxia, acidosis, and hypercapnia contribute to pulmo
nary vasoconstriction. Cor pulmonale may occur in the setting of
lung parenchymal disease, pulmonary vascular disease, congenital
heart disease, or impaired mobility of the thorax (Table 11-8).
Cor pulmonale may be acute or chronic. Acute cor pulmonale
is the sudden occurrence of pulmonary hypertension, which most
often occurs in the setting of massive pulmonary emboli. Chronic
cor pulmonale, in contrast, is much more common and is often
associated with chronic obstructive pulmonary disease and pulmo
nary fibrosis.
Grossly, the right ventricle is hypertrophic with a wall thick
ness often greater than 1 cm (normal thickness is 0.3–0.5 cm). Often
the right ventricle and right atrium appear dilated. Microscopically,
the changes are the same as those seen in left ventricular 
hypertension, including increased di
Causes of Cor Pulmonale
Parenchymal diseases of the lung Congenital heart diseases
Chronic bronchitis and Impaired movement of the thoracic
emphysema cage
Pulmonary fibrosis (from any Kyphoscoliosis
cause) Pickwickian syndrome
Cystic fibrosis Pleural fibrosis
Neuromuscular disorders
Pulmonary Vascular Diseases Idiopathic hypoventilation
Recurrent pulmonary emboli
Primary pulmonary hypertension
Peripheral pulmonary stenosis
Intravenous drug abuse
Residence at high altitude
Schistosomiasis

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