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January 3, 1948

Current Comment

JAMA. 1948;136(1):44. doi:10.1001/jama.1948.02890180046011

COR PULMONALD  Hypertrophy of the right ventricle of the heart, "cor pulmonale," occurs in acute, subacute or chronic form. The acute form is commonly caused by massive pulmonary emboli; death may result almost immediately. The subacute form, least frequent, is oftenest due to secondary carcinomatous infiltration of the perivascular lymphatics and of the pulmonary arterioles; occasionally the subacute lesion follows embolism of the smaller pulmonary vessels.1 Similar changes in the right ventricle have been found in sickle cell anemia attended by multiple disseminated thromboses of the smaller pulmonary arteries.2 Chronic cor pulmonale, commonest of the varieties, is associated with a greater number of anatomic changes. In 110 postmortem examinations3 enlargement of the right side of the heart was traceable to chronic obstructive emphysema in 72 (65.4 per cent). Other causes such as silicosis and bronchiectasis, tuberculosis, bronchial asthma, silicotuberculosis, kyphoscoliosis and pulmonary arteriolar sclerosis were present less