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Haemodynamic Dysfunction
 
Haemodynamic Dysfunction
 

Right Ventricular Failure

 
 
 
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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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