Right ventricular heart failure

Question 1

What is the definition of right ventricular heart disease?

Answer 1

Syndrome that results from any structural or functional cardiac disorder in the RV that impairs the ability of the heart to function as a pump

Question 2

How common is right ventricular heart disease?

Answer 2

1 in 20 people can suffer

Question 3

What is the pathophysiology of right ventricular heart disease?

Answer 3

• Left sided heart failure: blood backs up into left atrium, in the lungs and then the right ventricle
• COPD: ↑ BP in the pulmonary arteries ↑ workload of the right ventricle
• Coronary artery disease: left or right sided failure by blocking blood supply to either ventricle

Question 4

What is the aetiology/risk factors for right ventricular heart disease?

Answer 4

• Coronary artery disease
• Left sided heart failure
• COPD
• Congenital heart disease
• PE
• Pulmonary hypertension
• Heart valve disease

Question 5

What are the signs/symptoms of right ventricular heart disease?

Answer 5

• SOB
• Peripheral oedema
• Nocturia
• Palpitations
• Fatigue
• Fainting
• Murmur
• Pulmonary effusion
• Hepatomegaly
• Weight gain

Question 6

What investigations would be carried out for suspected right ventricular heart disease?

Answer 6

• CXR
• ECG
• Echocardiogram
• FBC, LFTs, TFTs
• BNP
• Urinalysis

Question 7

What are the surgical treatments for right ventricular heart disease?

Answer 7

• Valve replacement
• Coronary artery bypass surgery
• Bi-ventricular pacemaker
• Implantable cardioverter-defibrillator
• Heart transplant

Question 8

What are the pharmacological treatments for right ventricular heart disease?

Answer 8

• Diuretics
• ACE inhibitors, ARBs, long acting nitrates - ↓ hearts work load
• Beta blockers
• Digoxin

Question 9

What are the non pharmacological treatments for right ventricular heart disease?

Answer 9

• ↓ salt, alcohol and fluid intake
• Weight loss
• Smoking cessation