Right Ventricular Failure

Question 1

What is it?

Answer 1

When the right side of the heart fails to pump blood efficiently to the lungs

Question 2

What is the main cause?

Answer 2

As blood begins to build up behind a failing left ventricle, the right ventricle can no longer pump blood to the lungs

Question 3

What are the other causes? (7)

Answer 3

1. Chronic lung disease such as COPD, P.E, Pulmonary Hypertension
2. Coronary artery disease
3. Pulmonary Stenosis
4. Tricuspid Stenosis
5. Tricuspid regurgitation
6. Pericardial Constriction
7. Left-to-right shunt

Question 4

What does it result in?

Answer 4

It causes congestion affecting the liver, GI tract and the limbs

Question 5

Is it common?

Answer 5

Yes, 1 in 20 elderly people suffer from it

Question 6

Symptoms (5)

Answer 6

Dyspnoea, swelling of feet and ankles, nocturia, fatigue, weakness

Question 7

Signs (6)

Answer 7

Pronounced neck veins, murmur, raised JVP, hepatomegaly, ascites, pitting oedema

Question 8

What bloods would you do? (9)

Answer 8

FBC, U&E, LFT, CRP, BNP, Lipids, Clotting, Glucose, TFT

Question 9

Other investigations (5)

Answer 9

ECG, ECHO, Chest xray, Urinalysis, TOE

Question 10

What is the treatment?(10)

Answer 10

Reduce exacerbating factors such as salt and fluid intake, encourage weight loss, reduce alcohol and stop smoking
Diuretics such as furosemide or spironolactone, ACE Inhibitors, ARB’s, Isosorbide Mononitrates, Beta Blockers, Valve replacements if valvular cause

Question 11

Complications (3)

Answer 11

Arrhythmias, syncope, side effects of medications

Question 12

Is there a good prognosis?

Answer 12

No its poor, <25% survive 5 years from the diagnosis