Right ventricular dysfunction

Right ventricular dysfunction usually results from either pressure overload, volume overload, or a combination. 

It occur in a number of clinical scenarios, including:

  • pressure overload  
  • cardiomyopathies: ischemic, congenital
  • valvular heart disease
  • arrhythmias
  • sepsis

It can manifest as right heart strain.

Sustained ventricular dilatation and hypertrophy can frequently progresses to right ventricular failure.

Two dimensional echocardiography is usually considered the mainstay for analysis of right ventricular function. 

Features include

Right ventricular wall can be thickened (> 4 mm) (often observed in congenital heart disease) or dilated (in acquired heart disease).

The free wall can be hypokinetic; this is best appreciated from parasternal long axis projections.

May have a role in assessment. Suggestive signs include:

  • RVD (RV/LV ratio, >1.0) 5

Several phenotypical pattern have been described 9.

  1. pressure overload
  2. volume overload
  3. volume overload plus left ventricular dysfunction: considered 2nd commonest pattern
  4. depressed biventricular function: considered commonest pattern
  5. mixed overload, as there is co-existing biventricular dysfunction (in different degrees depending on disease duration), dilatation and right ventricular hypertrophy

 

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Article information

rID: 55495
Systems: Chest, Cardiac
Synonyms or Alternate Spellings:
  • RV dysfunction

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