Cor pulmonale

Clinical Manifestations

Acute RV failure causes pallor, sweating, hypotension, and a rapid pulse of small amplitude. The neck veins are distended and often exhibit prominent v waves secondary to tricuspid regurgitation. The liver may be pulsatile, distended, and tender. A systolic murmur of tricuspid regurgitation along the left sternal border may be accompanied by a presystolic (S4) gallop sound. Arterial blood gas frequently shows reduced PaO₂ due to ventilation/perfusion mismatching and a low PaCO₂ due to hyperventilation.