30 RHF

Question 1

compare the stroke volume of the RV to the LV

compare the EF of the RV and LV

Answer 1

stroke volumes are the same

RV has a lower EF

RV starts with a larger volume so it can produce the same SV as the LV with a lower EF

Question 2

why does the right ventricle have trouble with increases in pressure and volume

Answer 2

the right ventricle is relatively thin

Wall tension = pressure*radius/(2*wall thickness)

the less thick a wall is, the more senstitive it is to pressure/volume(radius) changes

Question 3

what type of MI causes RV ischemia

which leads are going to have abnormalities?

Answer 3

inferior MI

aVF, II, III are the inferior leads

Question 4

for inferior MIs causing RV failure, how is the patient managed

Answer 4

manage hypotension with fluids(only way to keep SV up)

add inotropes if fluids dont improve SV

Question 5

describe management of acute RV failure NOT involving an inferior MI(different strategy)

Answer 5

diuretics are useful to prevent excessive filling of the RV and a detrimental effect on SV

inotropes(mirenon/dobutamine) can be used to maintain SV along with diuretics

Question 6

symptoms of chronic RV failure

Answer 6

dsypnea, fatigue, lethargy

exertional syncope

anorexia

abdominal swelling, edema

Question 7

cor pulmonale

Answer 7

subgroup of RV failure w/lung disease

• COPD, interstitial lung disease, etc

hypoxemia leads to constriction of vessels in that part of the lung(body wants to shunt it to a better ventilated area); however if the whole lung is diseased, this just makes a lot of HTN for the RV to push against

Question 8

most common cause of RV failure

Answer 8

LV failure!

in LV failure, RV failure is a sign that things are BAAAAD