Thin as well as fat people may chronically underbreathe and, though their lungs are normal, the resulting hypoxia may lead to pulmonary hypertension and even to cor pulmonale. Cardiac therapy may then allow a level of breathing which partly corrects hypoxia and hypercapnia, thus breaking the vicious cycle which contributed to the heart failure initially. One cannot treat the lesion in the medullary respiratory center, but treatment of heart failure, artificial ventilation, and oxygen may, as in the present case, permit the patient to return to work. Prevention of heart failure then allows a level of breathing which partly corrects anoxia and hypercapnia and, in turn, prevents recurrent episodes of heart failure.
Grant JL, Arnold W. Idiopathic Hypoventilation. JAMA. 1965;194(2):119–122. doi:10.1001/jama.1965.03090150011002
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