Topic overview

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Cor pulmonale can develop in conditions such as COPD, interstitial lung disease, obstructive sleep apnea, and chronic thromboembolic disease. Persistent hypoxia may cause pulmonary vasoconstriction and vascular remodeling, raising pulmonary vascular resistance and increasing pressure on the right ventricle. Patients may experience exertional dyspnea and fatigue, with findings such as peripheral edema, jugular venous distension, or a loud P2. Evaluation may include echocardiography, ECG, chest radiography, laboratory testing, and right-heart catheterization. Management focuses on the underlying disease, oxygenation, and congestion; long-term oxygen is a cornerstone when specified oxygenation thresholds are met. The lesson also distinguishes supportive therapies from pulmonary vasodilators, which are reserved for proven pulmonary arterial hypertension.