Abstract
Cor pulmonale is manifested by nonspecific symptoms and subtle signs. A high index of clinical suspicion is essential for diagnosis, especially in patients with predisposing conditions. History taking and physical examination assist for diagnostic approach. Pulmonary component of the second heart sound often tends to increase in intensity as a result of pulmonary hypertension and elevation of A and V waves of the jugular venous pulse. The chest radiograph shows right heart enlargement and an increase in the pulmonary artery diameter. The most frequent abnormalities in the electrocardiogram are characterized by tall R wave in lead aVR y V1 and right bundle branch block. The echocardiogram shows right ventricular dysfunction and elevated pulmonary arterial pressure, which is confirmed by right heart catheterization. Use of computed tomography, pulmonary ventilation/perfusion scan and pulmonary function tests can be indicated to elucidate the etiology.
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