Break on Through to The Other Side: On Management of Acute Right Heart FailureEveryday EBM - February 4, 2015 - Submitted by Maia Dorsett
Clinical Takehome: The right ventricle reacts poorly to acute rises in pulmonary vascular resistance. RVF may be seen in a wide-variety of critically ill patients in the ED, including those with prexisting pulmonary hypertension, PE, sepsis, ARDS, and acute MI. Acute management of most right heart failure involves optimizing preload, maximizing RV perfusion and contractility, and decreasing afterload. You should probably throw the cardiac US probe on these patients to evaluate the cause of their hypotension and the effectiveness of your interventions. Even with aggressive intervention, acute RV failure carries a poor prognosis.
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