Overview
Right heart failure typically manifests with peripheral overload - resulting in findings such as a raised JVP, peripheral oedema, pleural effusions and ascites.
Pathogenesis
Causes of Right Ventricular Failure
- Pulmonary hypertension - pulmonary arterial hypertension, left heart failure, lung disease, chronic pulmonary embolism
- Right ventricular pathology - cardiomyopathy, myocarditis, ischaemic heart disease
- Tricuspid regurgitation - rheumatic heart disease, infective endocarditis, Ebstein's anomaly, carcinoid syndrome, trauma
- Pericardial disease - constrictive pericarditis
Manifestations
Signs of Right Ventricular Failure
- Sarcopaenia (muscle wasting)
- Tachycardia
- Raised jugular venous pressure
- Right ventricular heave
- Palpable P2
- Loud second heart sound (P2)
- Pleural effusions - reduced breath sounds with dull percussion note basally
- Ascites - fluid thrill / shifting dullness
- Tender hepatomegaly
- Peripheral oedema - sacral / pedal
Complications of Right Ventricular Failure
- Arrhythmias - atrial fibrillation, ventricular arrhythmias
- Sarcopaenia
- Ascites
- Peripheral oedema
- Cardiac cirrhosis
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