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May 26, 1978

The Treatment of Cor Pulmonale

Author Affiliations

From the Division of Pulmonary Medicine, University of Florida College of Medicine, Gainesville.

JAMA. 1978;239(21):2283-2285. doi:10.1001/jama.1978.03280480075029

COR PULMONALE is broadly defined as alteration of the structure or function of the right ventricle as a result of disease or dysfunction of the lungs.1,2 The constant feature of this disorder is pulmonary hypertension in response to which the right ventricle may dilate, hypertrophy, or subsequently fail. Chronic obstructive lung disease (COLD) is the most common cause of cor pulmonale, but it also may be seen with many other lung diseases, in persons with normal lung function residing at high altitudes, or as a result of hypoventilation, as in the syndromes of primary alveolar hypoventilation or sleep apnea.

PATHOPHYSIOLOGY  The modern approach to the therapy of cor pulmonale is based on extensive investigation into the mechanisms that cause pulmonary hypertension and into the physiological changes that accompany it. Several excellent reviews have summarized this wealth of information.1-3 It is generally agreed that the most potent stimulus to