eMedicine Specialties > Cardiology > Myocardial Disease and Cardiomyopathies

Cor Pulmonale: Follow-up

Author: Ali A Sovari, MD, Research Fellow, Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles (UCLA)
Coauthor(s): Ravi H Dave, MD, Associate Professor of Medicine, University of California at Los Angeles David Geffen School of Medicine; Abraham G Kocheril, MD, FACC, FACP, Professor of Medicine, Director of Clinical Electrophysiology, University of Illinois at Chicago
Contributor Information and Disclosures

Updated: Sep 3, 2008

Follow-up

Further Inpatient Care

Appropriate treatment is directed both at the underlying etiology and at correction of hypoxia when present.

Further Outpatient Care

  • Patients with cor pulmonale generally require close attention in the outpatient setting.
  • Regular assessment of oxygen needs and pulmonary function are appropriate.
  • Many patients benefit from a formal program of pulmonary rehabilitation.

Complications

Complications of cor pulmonale include syncope, hypoxia, pedal edema, passive hepatic congestion, and death.

Prognosis

  • The prognosis of cor pulmonale is variable depending upon underlying pathology.
  • Patients with cor pulmonale due to COPD have a high 2-year mortality.

Patient Education

Patient education regarding the importance of adherence to medical therapy is vital because appropriate treatment of both hypoxia and underlying medical illness can improve mortality and morbidity.

Miscellaneous

Medicolegal Pitfalls

  • Making a diagnosis of cor pulmonale should be followed by further investigation to determine the underlying lung pathology. Sometimes a common lung disease such as COPD is not the only lung pathology as the cause of cor pulmonale; other lung diseases may coexist.
  • When diagnosing cor pulmonale, considering the possibility of thromboembolic disease and primary pulmonary hypertension as possible etiologies is important.
  • Note the importance of continuous supplemental oxygen therapy in appropriate patients, as well as the dangers of cigarette smoking while using supplemental oxygen. Elevation of carboxyhemoglobin in the blood due to smoking can significantly decrease the effect of O2 on arterial O2 content.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Robert S Crausman, MD, MMS and Nidal A Yunis, MD to the development and writing of this article.



More on Cor Pulmonale

Overview: Cor Pulmonale
Differential Diagnoses & Workup: Cor Pulmonale
Treatment & Medication: Cor Pulmonale
Follow-up: Cor Pulmonale
References
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Further Reading

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Keywords

cor pulmonale, right heart failure, right ventricular failure, right ventricular hypertrophy, RVH, right ventricular dilatation, pulmonary hypertension, idiopathic primary pulmonary hypertension, cardiopulmonary disease, emphysema, pulmonary thromboembolism, interstitial lung disease, polycythemia vera, sickle cell disease, macroglobulinemia, chronic obstructive pulmonary disease, COPD, chronic bronchitis, pulmonary embolism, pulmonary emboli

exertional dyspnea, syncope with exertion, cor pulmonale, cough, hemoptysis, hoarseness, jaundice, hyperresonance to percussion, diminished breath sounds, wheezing, distant heart sounds, cyanosis, diastolic pulmonary regurgitation murmur, prominent A wave, distended neck veins, right ventricular third heart sound, holosystolic tricuspid insufficiency murmur, pulsatile liver, peripheral edema

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Contributor Information and Disclosures

Author

Ali A Sovari, MD, Research Fellow, Division of Cardiology, David Geffen School of Medicine, University of California, Los Angeles (UCLA)
Ali A Sovari, MD is a member of the following medical societies: American College of Physicians, American Heart Association, and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Ravi H Dave, MD, Associate Professor of Medicine, University of California at Los Angeles David Geffen School of Medicine
Disclosure: Nothing to disclose.

Abraham G Kocheril, MD, FACC, FACP, Professor of Medicine, Director of Clinical Electrophysiology, University of Illinois at Chicago
Abraham G Kocheril, MD, FACC, FACP is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, Cardiac Electrophysiology Society, Central Society for Clinical Research, Heart Failure Society of America, Heart Rhythm Society, and Illinois State Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Gregory Joseph Dehmer, MD, Director, Division of Cardiology, Professor, Department of Medicine, Scott & White Clinic, Texas A&M University School of Medicine
Gregory Joseph Dehmer, MD is a member of the following medical societies: American College of Cardiology, American Heart Association, Society for Cardiac Angiography and Interventions, and Society of Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Steven J Compton, MD, FACC, FACP, Director of Cardiac Electrophysiology, Alaska Heart Institute, Providence and Alaska Regional Hospitals
Steven J Compton, MD, FACC, FACP is a member of the following medical societies: Alaska State Medical Association, American College of Cardiology, American College of Physicians, and Heart Rhythm Society
Disclosure: Nothing to disclose.

CME Editor

Amer Suleman, MD, Consultant in Electrophysiology and Cardiovascular Medicine, Department of Internal Medicine, Division of Cardiology, Medical City Dallas Hospital
Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

Chief Editor

Eric H Yang, MD, Assistant Professor of Medicine, Director of Coronary Care Unit, University of North Carolina at Chapel Hill School of Medicine
Eric H Yang, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Up to Date Royalty Review panel membership

 
 
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