Pulmonary Heart Disease Symptoms: What Happens when the Right Side of the Heart Fails?

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About Pulmonary Heart Disease

Pulmonary heart disease is a condition in which chronic high blood pressure (hypertension) in the pulmonary blood vessels of the lungs causes damage to the heart. This occurs as a result of long-term pulmonary hypertension. The right side of the heart pumps oxygen-poor blood, which has returned from the body, onto the lungs in order to receive oxygen. The oxygen-rich blood returns to the left side of the heart and continues to circulate to the rest of the body’s tissues. When the vessels in the lungs constrict or are blocked, the blood pressure rises and causes the right side of the heart to pump harder than normal to compensate.

Professionals categorize pulmonary hypertension based upon its underlying cause. When it appears with no specific cause, it is termed idiopathic. However, it is often associated with another disorder and called secondary pulmonary hypertension.

Over a sustained period, which varies from patient to patient, pulmonary hypertension causes the right lower chamber (ventricle) of the heart to fail; pulmonary heart disease occurs whens the right ventricle fails to overcome the abnormally high pressure. Pulmonary heart disease is also known as cor pulmonale. There exist specific pulmonary heart disease symptoms, but some are caused by the underlying pulmonary hypertension. Cor pulmonale can be acute or chronic. Acute cor pulmonale usually occurs as a result of serious pulmonary embolism, or a blood clot from another part of the body that has traveled to the lungs and blocked an artery there. Chronic obstructive pulmonary disease (COPD) is the most common cause of chronic cor pulmonale, but other conditions can result in right ventricular failure.

Chest Discomfort

Often an early sign of any problem with the heart is discomfort or pain in the chest. Cor pulmonale is no different in this regard. Patients may experience discomfort as a result of lack of blood flow (ischemia) or as a result of an abnormal rhythm (arrhythmia) or thumping heart beat (palpitations).

Exercise Intolerance

For patients suffering from pulmonary heart disease, exercise and physical activity will be difficult to bear. The insufficient supply of oxygenated blood will make any activity strenuous. Patients will fatigue easily and require frequent rest.


Patients with cor pulmonale may present with impaired systemic circulation. This is evident in the manifestation of swelling (edema) in the legs and ankles.

Fluid Collection

As with the lower extremities, the patient may display an abnormal collection of fluid in the abdomen.

Neck Veins

The veins in the neck may appear swollen or stretched upon examination. This is indicative of high pressures in the right side of the heart.

Enlarged Liver

Another symptom of cor pulmonale is enlargement of the liver, or hepatomegaly. However, this may occur as a result of several other disease processes.

Pulmonary Hypertension Symptoms

Several of the pulmonary heart disease symptoms mirror those of the underlying pulmonary hypertension. Shortness of breath (dyspnea) will occur at first during exercise and then progress to occurring during rest. Wheezing and coughing will present often in conjunction with dyspnea. The diminished blood flow will cause a bluish hue in lips, skin, fingertips and toes, called cyanosis. Patients may also experience dizziness or fainting (syncope).


Merck Manual Professional: Cor Pulmonale

University of Maryland Medical Center: Cor Pulmonale-Symptom

MedlinePlus Medical Encyclopedia: Cor Pulmonale

Journal of Advance Practice Nursing: Management of Cor Pulmonale

Mayo Clinic: Pulmonary Hypertension: Symptoms

American Heart Association: Pulmonary Hypertension