title: The Assessment of the Right Heart Failure Syndrome.
abstract: The right heart failure (RHF) syndrome is a pathophysiologically complex state commonly associated with dysfunction of the right ventricle (RV). The normal RV is suited for its purposes of distributing venous blood to the low-resistance pulmonary circulation. Myriad stresses imposed upon it, though, can ultimately result in its failure, with the threat of cardiovascular collapse being the most dreaded outcome. Decreased cardiac output with increased central venous pressures are hemodynamic hallmarks of this highly morbid condition. Proper management of RHF is predicated on the accurate assessment of the key hemodynamic and clinical components signaling the syndrome that is the result of the failing RV. Appropriate use of diagnostic tools is paramount for understanding the key components of RV function: the preload state of the RV, its contractility, and the afterload burden placed on it. In making these assessments, it remains crucial to understand the limitations of these tools when managing RHF in the intensive care unit. An understanding of each of these components allows for the understanding of the physiology and the clinical presentation which can guide the use of therapies appropriately tailored to manage the condition.
authors.affiliation: Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University, Stanford, California.
authors.forename: Cyrus A
authors.initials: CA
authors.lastname: Kholdani
authors.affiliation: Division of Cardiology, Liu Center for Pulmonary Hypertension, LA Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Oudiz
authors.affiliation: Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Wassim H
authors.initials: WH
authors.lastname: Fares
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D006333:Heart Failure / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D011652:Pulmonary Circulation; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*; D016278:Ventricular Function, Right / Q000502:physiology; D014944:World Health Organization