Cor pulmonale. Treatment implications of right versus left ventricular impairment

Diagnosing cor pulmonale and detecting left ventricular dysfunction in patients with advanced lung disease are difficult challenges. Usually, routine clinical assessment (history, physical examination, chest radiography, and electrocardiography) is inadequate and additional cardiac diagnostic techniques (eg, two-dimensional echocardiography, first-pass radionuclide angiography) are required for definitive documentation. Diagnosis of cor pulmonale and evaluation of cardiac function in patients with advanced lung disease are of more than academic interest. Long-term oxygen therapy, the main treatment option, improves survival rate in these patients. Establishing the coexistence of left ventricular dysfunction is important, because management of congestive heart failure offers little benefit and may even be harmful in patients with cor pulmonale.