The heart becomes diseased as a result of an abnormality in the lungs. Chronic pulmonary disease raises pulmonary resistance and results in right heart enlargement.

Causes include:

  • Primary chronic lung disease E.g. Fibrosis.
  • Thromboembolic obstruction of pulmonary arterioles E.g. metastatic neoplasia, lungworm in dogs.
  • Impairment of repiratory motion E.g thoracic trauma.

Grossly, the right heart is dilated with pulmonary and peripheral oedema.