Which finding is most consistent with cor pulmonale?

• A. Cyanosis only
• B. Increased jugular venous pressure
• C. Bilateral flank tenderness
• D. Decreased breath sounds

Answer: (B)

Cor pulmonale occurs when chronic lung disease causes pulmonary hypertension that strains and ultimately fails the right side of the heart. The most consistent clinical sign of this right-sided heart failure is elevated jugular venous pressure, reflecting systemic venous congestion as the right ventricle can’t effectively move blood into the pulmonary circulation. You may also see other signs like edema or liver enlargement, but the raised neck veins are the hallmark. Cyanosis can occur with long-standing hypoxemia, but it’s less consistently present than the venous congestion sign. Bilateral flank tenderness and decreased breath sounds aren’t typical indicators of cor pulmonale itself, since they point more to renal, abdominal, or primary lung issues rather than right-heart failure.