Chronic cor pulmonale: a clinical study of 100 cases

1. The pathological diagnosis of chronic cor pulmonal is discussed and criteria suggested. 2. The pathological, clinical, and electrocardiographic findings in 100 cases of uncomplicated chronic cor pulmonale are described. Necropsy with separation and weighing of right and left ventricles was carried out in 43 cases. 3. It was found that many cases of chronic cor pulmonale die from anoxia before right ventricular hypertrophy is detectable, and with minimal heart failure. 4. It is suggested that two processes are at work, one tending to produce anoxia and the other right ventricular hypertrophy. The relative importance of the two processes varies from case to case. It is suggested that the rate of progress of the lung disease may determine which process predominates. 5. The diagnosis, treatment and prognosis of chronic cor pulmonale is discussed. The importance of recognising occult acute respiratory infection and the value of antibiotics in treatment is stressed. 6. The magnitude of the problem of chronic lung disease in large industrial areas is pointed out. Improvement can only be brought about by an amelioration in the town-dweller's environment, in which reduction of atmospheric pollution is the most important factor.