W.B. Saunders Co. Reproduced from J. Clin. Cor pulmonale refers to any right ventricular manifestation of pulmonary hypertension caused by lung disease. Cor pulmonale is not synonymous with right heart failure. Perhaps the most common cause of pulmonary hypertension is left heart failure. In left heart failure fluid backs up in the left atrium and in the pulmonary circulation, resulting in increased pulmonary artery pressures.
Treatment is usually with digoxin and diuretics and is directed at the left ventricle.
Unless the patient is hypoxemic, supplemental oxygen can be expected to have little benefit. Both conditions are easily diagnosed using noninvasive cardiac methods and are potentially correctable with mitral valve surgery. Years ago rheumatic fever was the principal cause of severe mitral valve disease. Rheumatic heart disease is now relatively uncommon in the United States, and as a consequence, the prevalence of severe mitral valve disease has decreased over the years. Nonetheless, mitral valve disease should always be considered when pulmonary hypertension is present without an obvious cause.