A patient, age 68, has a long history of COPD and is admitted to the hospital with cor pulmonale. He says his doctor said his heart was failing and asks whether he is having a heart attack. Which explanation by the nurse is most correct?

A. "It could be a heart attack, and when the heart is damaged it causes respiratory damage, too.” This misrepresents the pathophysiology of cor pulmonale. Cor pulmonale results from lung disease impacting heart function, not vice versa. B. "It isn't a heart attack, but your heart has gradually weakened over the years, causing respiratory disease." In cor pulmonale, chronic respiratory disease leads to right-sided heart failure not the other way around. C. "It is probably a heart attack, since cor pulmonale means that the heart isn't getting enough blood and becomes too weak to pump effectively." Cor pulmonale, is not about coronary blood flow but rather the increased pulmonary pressure due to chronic lung disease that strains the right side of the heart. D. "You aren't having a heart attack, but your heart has been damaged by changes in your lungs caused by your respiratory disease." Cor pulmonale is right-sided heart failure caused by chronic lung disease such as COPD. Increased resistance in the pulmonary circulation puts strain on the right ventricle, leading to its dysfunction.