Right Ventricular Failure RVF Occurs when the right

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 – – – – 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.