Cor pulmonale is one of the complications of emphysema and is caused by an increase in blood pressure in the pulmonary artery, the vessel that carries blood from the heart to the lungs. This leads to enlargement and subsequent failure of the right side of the heart. Consequences of cor pulmonale: Chronic congestion in the centrilobular region of the liver leads to hypoxia and fatty changes of more peripheral hepatocytes, leading to nutmeg liver.