Cor Pulmonale (Right-Sided Heart Failure): Symptoms, Causes, Diagnosis and Treatment — What You Need to Know
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Quick Answer: Cor pulmonale is an enlarged, overworked right ventricle in your heart caused by a lung condition. It is a type of right-sided heart failure: lung problems cause high blood pressure in the pulmonary artery, so the right ventricle must push harder, grows larger, and eventually fails. It accounts for an estimated 6% to 7% of heart disease cases in the United States, with COPD the top cause of the long-term form. Symptoms like shortness of breath, leg or belly swelling, and fainting tend to appear only after the condition has developed. Treatment targets the underlying lung disease, and the sooner it starts, the better the chance of preventing permanent heart damage.
What Is Cor Pulmonale?
The definition of cor pulmonale (pulmonary heart) is when a lung issue causes your right ventricle, one of your heart's chambers, to get so big that your heart starts to fail. It is a type of right-sided heart failure.
Normally, your right ventricle sends blood to your pulmonary artery to get oxygen from your lungs. But certain lung conditions cause high blood pressure in your pulmonary artery. That makes it harder for your right ventricle to get blood to your lungs.
Your right ventricle has to push against higher pressure in your pulmonary artery, where blood pressure is normally low. Think of it like opening a car door when it is windy outside: you have to push against the wind. When your right ventricle has to keep working harder than normal, it gets larger and doesn't work well.
What are the types?
Cor pulmonale comes in two forms. Acute cor pulmonale is short-term. Chronic cor pulmonale is long-term, and most cases are chronic.
How common is it?
Cor pulmonale makes up an estimated 6% to 7% of heart disease cases in the United States.
TL;DR: The Short Version
Cor pulmonale is a heart problem caused by a lung problem. Lung conditions raise the blood pressure in the pulmonary artery, forcing the heart's right ventricle to push against the wind. Over time it enlarges and begins to fail. The chronic form is far more common, and COPD is its leading cause. Symptoms (shortness of breath, swollen legs or belly, chest pain, fainting) typically appear only after the condition has been developing for a while, which makes prompt evaluation important. Treatment is directed at the lung disease that caused it, and quick treatment can prevent permanent damage to your heart.
Cor pulmonale is an enlarged right ventricle in your heart that happens because of a lung condition. Having a medical condition that makes it hard to do everyday tasks can be frustrating. Ask family and friends for help if you need it. Your healthcare provider can explain your treatment options and which ones may work best for you.
When Should You Seek Care?
Cor pulmonale is a serious, usually long-term condition, and timing matters.
Situation | Why it matters |
Shortness of breath, swelling in legs or belly, chest pain, or fainting episodes | These symptoms tend to appear only after cor pulmonale has developed for a while, so get evaluated promptly |
A hospital stay for cor pulmonale | You'll need to follow up with a cardiologist (heart specialist) and a pulmonologist (lung specialist), often within a week or two |
A known lung condition plus any new heart-related symptom | Treatment that starts quickly can prevent permanent damage to your heart |
What Are the Symptoms of Cor Pulmonale?
Cor pulmonale symptoms include shortness of breath, bulging veins in your neck, swelling in your legs or belly, fatigue, chest pain, and fainting episodes. At first, you may not have symptoms. They happen when you've had cor pulmonale for a while, and they occur in addition to the symptoms of the lung condition that caused it.
Symptom | How it presents |
Shortness of breath | Difficulty breathing, often worsened by activity |
Bulging veins in your neck | Visible, distended neck veins |
Swelling in your legs or belly | Fluid buildup in the lower body or abdomen |
Fatigue | Persistent tiredness |
Chest pain | Discomfort in the chest area |
Fainting episodes | Passing out (syncope) |
What Causes Cor Pulmonale?
Cor pulmonale is caused by lung conditions that lead to pulmonary hypertension. Certain lung conditions cause high blood pressure in your pulmonary artery, where blood pressure is normally low, and the right ventricle has to keep working harder than normal.
Cause | Note |
Chronic obstructive pulmonary disease (COPD) | The top cause of long-term cor pulmonale |
A blood clot in the lungs | |
Trauma or surgery that removes lung tissue | Loss of lung tissue raises resistance |
Mechanical ventilation injury | Injury from the ventilator itself |
An autoimmune connective-tissue disease | |
A genetic lung disease | |
Neuromuscular disorders that affect breathing | Weakened breathing muscles strain the lungs |
Lung issues that block your veins | Obstruction raises pulmonary pressure |
Scarring of the lungs | |
Repeated breathing pauses during sleep | |
A curved spine that restricts the lungs |
What Are the Risk Factors?
Risk factors for cor pulmonale include using tobacco products, breathing polluted air, and having lung conditions that cause pulmonary hypertension.
What Are the Complications?
Complications of cor pulmonale may include abnormal heart rhythms, right heart failure, low oxygen levels (hypoxia), fainting episodes, kidney disease, liver disease, and death.
How Is Cor Pulmonale Diagnosed?
A healthcare provider may hear abnormal sounds when they listen to your heart with a stethoscope. They'll order tests to diagnose cor pulmonale.
Test | What it examines |
Echocardiogram | Heart structure and pumping function |
Chest X-ray | Lungs and heart size |
Electrocardiogram (EKG) | Heart's electrical activity |
Nuclear medicine imaging | Blood flow and organ function |
CT angiogram | Detailed images of blood vessels |
Heart MRI | Detailed heart anatomy |
VQ scan | Ventilation and blood flow in the lungs |
Right heart catheterization | Direct pressure measurements in the heart |
How Is Cor Pulmonale Treated?
Treatment focuses on improving the lung issue that caused it. Quick treatment is important to prevent permanent damage to your heart. The goals are to get more oxygen to your tissues if they need it, help your right ventricle work better, and keep the blood vessels in your lungs from constricting too much so blood can get through more easily.
Treatment | What it does |
Oxygen therapy | Gets more oxygen to your tissues |
Bronchodilators | Opens the airways |
Corticosteroids | Reduces inflammation |
Diuretics | Removes excess fluid |
Anticoagulants | Helps prevent blood clots |
Cardiac rehab | Supervised exercise and education |
Embolectomy | Surgical blood clot removal |
Pulmonary vasodilators | Relaxes lung blood vessels |
Lung or heart-lung transplant | Replaces the diseased organ(s) |
What are the side effects of these treatments?
Treatment | Possible side effect or complication |
Oxygen therapy | Headaches, fatigue, nosebleeds |
Medicines | Upset stomach, weight gain, mood changes, headache, bleeding |
Cardiac rehab | Injury, abnormal heart rhythm |
Embolectomy | Bleeding, injury, infection |
Lung transplant | Bleeding, infection, organ rejection |
What Can You Expect Long-Term?
Most people with cor pulmonale have a poor quality of life. Even with treatment, symptoms often come back.
Cor pulmonale is usually a long-term condition. However, cor pulmonale from a mechanical ventilation injury or pulmonary embolism is a short-term condition.
The condition that causes cor pulmonale determines the outlook. Without management of the lung condition that caused it, the outlook is poor. For instance, only 30% of people who get cor pulmonale from COPD live another five years.
How Do You Take Care of Yourself?
You can take care of yourself by taking the medicines your provider prescribed, attending all follow-up appointments, stopping tobacco products, exercising, and getting vaccines that can prevent or ease the flu or other conditions that affect your lungs. Your healthcare provider may also limit how much salt and fluid you eat and drink.
Questions to ask your provider
What caused cor pulmonale in my case?
What specific treatment do you recommend for me?
What's the outlook for my situation?
How much and what kind of exercise would be right for me?
Is there a support group for people in my situation?
The Bottom Line
Cor pulmonale is heart failure caused by lung disease. High pressure in the pulmonary artery, usually from a chronic lung disease like COPD, forces the right ventricle to push against the wind until it enlarges and fails. Because symptoms appear late, it often hides behind the lung condition that caused it. Treatment must target the underlying lung disease, it must start quickly to prevent permanent heart damage, and the lung condition itself determines the outlook. Taking prescribed medicines, attending follow-up visits with both a cardiologist and a pulmonologist, avoiding tobacco, exercising as advised, limiting salt and fluid when instructed, and staying vaccinated all give you more control.
Take action today: if you have a lung condition and notice shortness of breath, swelling, chest pain, or fainting that is new or worsening, contact a healthcare provider promptly. If you have just been hospitalized for cor pulmonale, schedule your cardiology and pulmonology follow-up within the next week or two.
Frequently Asked Questions
What is cor pulmonale?
Cor pulmonale (pulmonary heart) is when a lung issue causes your right ventricle to get so big that your heart starts to fail. It is a type of right-sided heart failure.
What causes cor pulmonale?
Lung conditions that cause pulmonary hypertension, such as COPD, pulmonary embolism, scleroderma, cystic fibrosis, pulmonary fibrosis, obstructive sleep apnea, kyphosis, neuromuscular breathing disorders, mechanical ventilation injury, and trauma or surgery that removes lung tissue.
What is the top cause of long-term cor pulmonale?
Chronic obstructive pulmonary disease (COPD).
How common is cor pulmonale?
It makes up an estimated 6% to 7% of heart disease cases in the United States.
What are the symptoms?
Shortness of breath, bulging veins in your neck, swelling in your legs or belly, fatigue, chest pain, and fainting episodes. At first, you may not have symptoms.
How is it diagnosed?
A provider may hear abnormal sounds with a stethoscope, then order tests such as an echocardiogram, chest X-ray, EKG, nuclear medicine imaging, CT angiogram, heart MRI, VQ scan, and right heart catheterization.
How is it treated?
Treatment focuses on improving the lung issue that caused it and may include oxygen therapy, bronchodilators, corticosteroids, diuretics, anticoagulants, cardiac rehab, embolectomy, pulmonary vasodilators, and lung or heart-lung transplant.
Why is quick treatment important?
Quick treatment is important to prevent permanent damage to your heart.
What is the outlook?
The condition that causes cor pulmonale determines the outlook. For instance, only 30% of people who get cor pulmonale from COPD live another five years.
Who should I see after leaving the hospital?
A cardiologist (heart specialist) and a pulmonologist (lung specialist), often within a week or two.
Related Reading
Sources
1. Cleveland Clinic. Cor Pulmonale (medically reviewed; last updated April 20, 2023). https://my.clevelandclinic.org/health/diseases/24922-cor-pulmonale
External references: StatPearls: Cor Pulmonale · Merck Manual Professional: Cor Pulmonale
Medical disclaimer: This article is for general informational purposes only and does not constitute medical advice. It is not a substitute for professional medical diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions regarding a medical condition. If you think you may have a medical emergency, call your doctor or emergency services immediately.
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