Diagnosis and Management of Chronic Cor Pulmonale

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Abstract
Diagnosis of chronic cor pulmonale often is difficult, particularly when caused by emphysema, because the distended lung conceals cardiac signs. When the condition is secondary to pulmonary fibrosis and primary pulmonary hypertension, characteristic signs are elicited more easily. The chest x-ray and electrocardiogram frequently are diagnostic in moderately advanced cor pulmonale resulting from primary pulmonary hypertension but are of little help when the basis is ventilatory insufficiency. Studies of arterial blood gases closely reflect ventilatory insufficiency. Pulmonary function tests assist in choice of therapy by elucidating the specific deject. Treatment of chronic cor pulmonale resulting from pulmonary vascular disease is largely ineffective. Therapy is more successful when the condition is secondary to ventilatory insufficiency. Simultaneous use of many agents often is necessary.