Cor Pulmonale Research Note

Provider Attempts

Falcon was attempted twice with just research-disorder falcon Cor_Pulmonale after exporting EDISON_API_KEY from /home/harry/dismech/edison_tok. Both runs remained active without writing research/Cor_Pulmonale-deep-research-falcon.md and were terminated after bounded waits. The generic cyberian fallback (just research-disorder cyberian Cor_Pulmonale) likewise remained active without producing a report. The repo-supported cyberian-codex fallback (just research-disorder-cyberian-codex Cor_Pulmonale) started but exited with code 137.

Because no provider report was available, curation used PubMed-backed references fetched with just fetch-reference. Evidence snippets in kb/disorders/Cor_Pulmonale.yaml were selected from the fetched cache files and validated locally.

Mechanistic Summary

Cor pulmonale is right ventricular hypertrophy, dilation, and/or right-sided heart failure secondary to respiratory-system disease, pulmonary vascular disease, or chronic gas-exchange impairment rather than primary left-heart disease. The curated page treats it as a complex cardiopulmonary disorder.

The main mechanistic chain is:

1. Chronic lung or pulmonary vascular disease causes pulmonary vascular-bed loss, narrowing, remodeling, and fibrosis.
2. Hypoxemia drives hypoxic pulmonary vasoconstriction, and endothelial dysfunction shifts mediator balance toward vasoconstriction and vascular remodeling.
3. Pulmonary hypertension and increased pulmonary vascular resistance raise right ventricular afterload.
4. Persistent right ventricular loading leads to hypertrophy, dilation, and eventual right-sided failure with systemic congestion.

Treatment curation was limited to claims directly supported by cached evidence: long-term oxygen therapy for hypoxemic COPD-related cor pulmonale; conditional PH-specific vasodilator therapy where evidence is limited; and cautious diuretic therapy for congestion.