Subacute Cor Pulmonale
  • This form of presentation occurs when small subliminal tumor deposits obstruct a sufficient cross section of the pulmonary vascular bed. 
  • The spectrum of pulmonary symptoms is identically to thromboembolism.
  •  Patients are in prolonged respiratory distress with normal chest x-ray and with or without signs of pulmonary hypertension. 
  • Choriocarcinoma, hepatoma, breast and stomach tumors account for most of the primaries with such presentation. 
  • This entity should be considered in a female with severe respiratory distress with a history of recent abortion or delivery chorionic gonadotropin levels are high. 
  • When recognized, chemotherapy offers a favorable prognosis in patients with choriocarcinoma. 
  • Prognosis is poor with other primary malignancies.