[Pathology of cor pulmonale. Idea and reality (author's transl)]

The diagnosis of chronic cor pulmonale is made by the pathologist, but not by the clinician. Chest x-ray, ECG and lung function tests are not conclusive for the diagnosis. Considering the different pathogenetic possibilities it is evident that more than one factor is involved in the development of cor pulmonale. Explanations for the different reactions in similar anatomical and functional situations may be the influence of genetic factors, a different sensitivity to alveolar hypoxia, a difference in developing of muscular hypertrophy and a difference in the development of bronchopulmonary anastomoses in inflammatory or degenerative lung disease. In this regard it is suggested to omit the term chronic cor pulmonale in clinical diagnosis and to refer instead to pulmonary hypertension, or radiological or electrocardiographical signs of right ventricular hypertrophy. It seems more important, to define the status, the changes or the actual disease of the lungs.