What is included in the evaluation for cor pulmonale?

Updated: Dec 15, 2017
  • Author: Derek Leong, MD; Chief Editor: Henry H Ooi, MD, MRCPI  more...
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A general approach to diagnose cor pulmonale and to investigate its etiology starts with routine laboratory tests, chest radiography, and electrocardiography (see the separate sections below). Echocardiography gives valuable information about the disease and right ventricular (RV) function, as well as assisting in determining the etiology of pulmonary hypertension and cor pulmonale. Right heart catheterization is the most accurate but invasive test to confirm the diagnosis of cor pulmonale and gives important information regarding underlying causes. [11, 12]

Once a diagnosis of cor pulmonale is made, it should be followed by further investigation to determine the underlying lung pathology. Sometimes a common lung disease such as chronic obstructive pulmonary disease (COPD) is not the only lung pathology causing cor pulmonale; other lung diseases may coexist. Thus, pulmonary function tests may be required to confirm the presence of other lung pathologies. Ventilation/perfusion (V/Q) scanning or chest computed tomography (CT) scanning may be performed if the patient’s history and physical examination suggest pulmonary thromboembolism as the cause or if other diagnostic tests do not provide a specific etiology.

Imaging studies may show evidence of underlying cardiopulmonary diseases, pulmonary hypertension, or RV enlargement. Cardiac magnetic resonance (CMR) imaging is another form of noninvasive imaging that does not use ionizing radiation. CMR can be used to evaluate cor pulmonale, and it is useful in determining RV structure, remodeling, and function; this modality is especially useful in assessing pulmonary artery dimensions when compared to traditional echocardiography.

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