The pathophysiology of<unk>  (cor pulmonale) has always indicated that an increase in right ventricular afterload causes RV failure (pulmonary vasoconstriction, anatomic disruption/pulmonary vascular bed and increased blood viscosity are usually involved ), however most of the time, the right ventricle adjusts to an overload in chronic pressure. According to Voelkel, et al., pressure overload is the initial step for changes in RV, other factors include: * Ischemia * Inflammation * Oxidative damage * Epigenetics * Abnormal cardiac energetics
Pulmonary heart disease
Asthma
Obstructive lung disease
Bronchopulmonary dysplasia
Chronic obstructive pulmonary disease
Pulmonary hypertension
Restrictive lung disease
Vocal cord dysfunction