Right Heart Failure

Question 1

What are the main causes of RHF?

Answer 1

Previous LHF (which increases pulmonary venous pressure, which leads to pulmonary arterial hypertension, which overloads the RV) OR by Cor Pulmonale, a severe lung disease.

Question 2

What are some other causes of RHF?

Answer 2

• Multiple pulmonary emboli
• RV infarction
• Primary pulmonary hypertension
• Tricuspid regurgitation or stenosis
• Pulmonary venous occlusive disease
• Congenital disorders (Ebstein anomaly, Eisenmenger syndrome)

Question 3

What are some systemic signs of RHF?

Answer 3

Peripheral oedema, ulcerations and tissue death due to decreased venous return and lack of oxygenation of blood

Question 4

Describe the pathogenesis of RHF

Answer 4

Right ventricle is unable to pump blood into the pulmonary system.
This leads to in blood volume in the ventricle, which leads to volume in the atrium (pooling of blood occurs).
blood volume and pressure in the systemic venous system increases and blood accumulates in some of the major organs like the liver, spleen, stomach, intestine causing them to become congested.
Increased pressure causes fluid extravasation and consequently oedema and ascites.

Question 5

Describe the most common signs and symptoms of RHF

Answer 5

Ankle swelling and fatigue

Question 6

What are some other signs and symptoms of RHF?

Answer 6

• Pitting oedema
• Enlargement of organs, splenomegaly and hepatomegaly
• Distended jugular veins
• Ascites
• Sensation of fullness in the abdomen or neck
• Anorexia and abdominal bloating (if stomach and intestinal congestion)
• Jaundice (liver damage)