Abstract:
Cor-pulmonale develops in response to acute or chronic changes in the pulmonary vasculature
and/or the lung parenchyma that are sufficient to cause pulmonary hypertension. The true prevalence of cor-
pulmonale is difficult to ascertain. However, recent advances in two dimensional echocardiography/Doppler
imaging and biomarkers make it easier to screen and detect cor-pulmonale.
Aim: To study the etiology of cor-pulmonale, and to correlate it with the clinical, chest x-ray (CXR),
electrocardiography (ECG) and echocardiography (ECHO) findings.
Methods: Fifty consecutive patients admitted with confirmed diagnosis of cor-pulmonale were included into
the study. Detailed history, clinical examination, ECG, CXR and ECHO were carried out in all the cases.
Results: Out of the 50 patients, 32 were males and 18 were females. Maximum incidence was seen in 50-69
age group comprising 60% of the cases with mean age being 55.2 years. Majority (56%) of patients had the
history of symptoms of more than 10 years duration. Chronic bronchitis was the underlying cause in the
largest number (54%) of patients. Majority of patients had evidence of pulmonary hypertension. Q/R ratio in a
VR >3 was observed in 60% of cases. On ECHO, right atrial enlargement was evident in 46% of patients and RVH
was evident in 94% of cases.
Conclusions: In patients with clinical diagnosis of chronic cor-pulmonale, chest x-ray is a poor tool for
detection of pulmonary hypertension, but gives information about its etiology. ECG provides information
about RVH and right atrial enlargement. Echocardiography is helpful in detecting all cases of cor-pulmonale
and to exclude pulmonary hypertension produced by left sided heart disease.
