A 60-year-old man with severe COPD develops peripheral edema, raised jugular venous pressure, and tender hepatomegaly. Echocardiography shows right ventricular hypertrophy and dilatation with normal left ventricular systolic function. Which finding is most specific for cor pulmonale?

• A Bilateral pitting pedal edema
• B Raised JVP with prominent V wave
• C Tender hepatomegaly
• D Right ventricular hypertrophy with normal left ventricular function ✓

Explanation

Cor pulmonale is defined as right ventricular enlargement or hypertrophy secondary to pulmonary hypertension caused by lung disease, with preserved left ventricular function. Edema, raised JVP, and hepatomegaly are signs of right heart failure but are nonspecific and occur in other conditions like constrictive pericarditis.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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