What is the role of drug treatment for cor pulmonale?

Updated: Dec 15, 2017
  • Author: Derek Leong, MD; Chief Editor: Henry H Ooi, MD, MRCPI  more...
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Answer

Answer

Diuretics are used to decrease the elevated right ventricular (RV) filling volume in patients with chronic cor pulmonale. Calcium channel blockers are pulmonary artery vasodilators that have some efficacy in the long-term management of chronic cor pulmonale secondary to primary pulmonary arterial hypertension (PAH). [25]

US Food and Drug Administration (FDA)–approved prostacyclin analogues and endothelin-receptor antagonists are available for treatment of pulmonary arterial hypertension (PAH). The beneficial role of cardiac glycosides, namely digitalis, on the failing right ventricle are controversial; these agents may improve RV function but must be used with caution and should be avoided during acute episodes of hypoxia.

The main indication for oral anticoagulants in the management of cor pulmonale is in the setting of an underlying thromboembolic event or PAH.

Methylxanthines, like theophylline, can be used as an adjunctive treatment for chronic cor pulmonale secondary to chronic obstructive pulmonary disease (COPD). Besides the moderate bronchodilatory effect of methylxanthine, this agent improves myocardial contractility, causes a mild pulmonary vasodilatory effect, and enhances diaphragmatic contractility.


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