Right Ventricular Failure (RVF)

• Occurs when the right ventricle fails as an effective forward pump, causing back-pressure of blood into the systemic venous circulation

• Can result from: – Chronic hypertension (in which LVF usually precedes RVF)– COPD– Pulmonary embolism– Valvular heart disease– Right ventricular infarction

• RVF most commonly results from LVF

RVF

• Signs and symptoms– Tachycardia– Venous congestion

• Engorged liver, spleen, or both• Venous distention; distention and pulsations of the neck veins

– Peripheral edema– Fluid accumulation in serous cavities– History--common signs and symptoms of acute right-

sided heart failure include chest pain, hypotension, and distended neck veins

• Management

Left Ventricular Failure (LVF) and Pulmonary Edema

• LVF occurs when the left ventricle fails to function as an effective forward pump, causing a back-pressure of blood into the pulmonary circulation

• May be caused by a variety of forms of heart disease including ischemic, valvular, and hypertensive heart disease

• Untreated, significant LVF culminates in pulmonary edema

LVF

• Signs and symptoms– Severe respiratory distress

– Severe apprehension, agitation, confusion

– Cyanosis (if severe)

– Diaphoresis

– Adventitious lung sounds

– JVD

– Abnormal vital signs

• Management

Cardiogenic Shock

• The most extreme form of pump failure• Occurs when left ventricular function is so

compromised that the heart cannot meet the metabolic needs of the body

• Usually caused by extensive myocardial infarction, often involving more than 40% of the left ventricle, or by diffuse ischemia

• Signs and symptoms• Management

Cardiac Tamponade

• Impaired diastolic filling of the heart caused by increased intrapericardial pressure and volume– As the volume of pericardial fluid encroaches on the

capacity of the atria and ventricles to fill adequately, ventricular filling is mechanically limited and stoke volume is decreased

• Causes• Signs and symptoms• Management

Cor Pulmonale

• A condition of Rt. Ventricular Failure due to pulmonary hypertension secondary to a disease of the pulmonary blood vessels.

• A pulmonary embolus can cause an acute dilatation of the ventricle requiring emergent measures.

• Chronic Cor Pulmonale develops from COPD/emphazema, and/or fibrosis.