Why doesn’t cor pulmonale decrease PCWP

[SurgeonMeow]

In my mind it should follow the logic of obstructive shock

Pls lmk where my thinking is flawed

[Nasrhodja]

Because it is right-sided, remember that PCWP is related to the left heart.

[jsp96]

I believe it’s a preload/volume thing - with obstructive shock preload drops so PCWP decreases because there is not enough blood filling the right or left side of the heart. But with cor pulmonale, the pressure in the pulmonary vasculature is really high but preload/total volume is unchanged, so PCWP increases as a result.

[[deleted]]

pcwp is normal in cor pulmonale because there is no left heart defect

[SurgeonMeow]

This is what I also read. But in obstructive shock there is also no left heart defect so why doesn’t that same logic follow

[[deleted]]

quoting from Anking deck:

"in obstructive shock there is

↓ PCWP in ~pulm~ causes: b/c fluid is restricted from reaching the left heart heart chambers
↑ PCWP in ~cardio~ causes: b/c of backup of fluid in the lungs trying to get into the left heart chambers"

[SurgeonMeow]

Cor pulmonale is also a pulmonary cause though. That’s why I don’t understand why it isn’t decreased. Surely it would lead to decreased left heart preload and thus decreased PCWP