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 rightsided 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
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–
–
–
–
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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.