Cor pulmonale (lung-related heart failure)

For a lay person:

Cor pulmonale is strain and failure of the right side of the heart caused by long-term lung disease, such as COPD, or by high blood pressure in the lungs. The heart has to work harder to pump blood through the damaged lungs, leading to breathlessness, tiredness and swelling of the legs and abdomen. It is a serious condition that needs ongoing medical care.

For a trained medical person:

Right ventricular hypertrophy and failure secondary to pulmonary hypertension from lung disease or hypoxaemia, most commonly COPD, and also interstitial lung disease, obstructive sleep apnoea and chronic thromboembolic disease. Diagnosis uses echocardiography, ECG, natriuretic peptides, blood gases and investigation of the underlying lung disease, with right-heart catheterisation where needed. Management treats the underlying lung disease, provides long-term oxygen for chronic hypoxaemia, uses diuretics for fluid overload, and treats exacerbations promptly.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Exterior Cold Phlegm; Exterior Heat Phlegm; Lung Deficiency with Phlegm Turbid; Yang Deficiency with Edema; Phlegm Obstructing the Shen and Orifices; Heart-Qi Deficiency; Yin Deficiency with Phlegm-Heat. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Seek emergency care for worsening breathlessness, chest pain, fainting, confusion or blue lips. This condition needs medical treatment and Chinese medicine is adjunctive at most; some herbs affect fluid balance, potassium or heart medicines, so check with your doctor before using them.