Diagnosis and Management of Pulmonary Hypertension and Right Ventricular Failure in the Cardiovascular Intensive Care Unit

Anika Vaidy; Oisin O'Corragain; Anjali Vaidya

doi:10.1016/j.ccc.2023.05.003

Diagnosis and Management of Pulmonary Hypertension and Right Ventricular Failure in the Cardiovascular Intensive Care Unit

Crit Care Clin. 2024 Jan;40(1):121-135. doi: 10.1016/j.ccc.2023.05.003. Epub 2023 Sep 7.

Authors

Anika Vaidy¹, Oisin O'Corragain², Anjali Vaidya³

Affiliations

¹ Pulmonary Hypertension, Right Heart Failure, CTEPH Program, Division of Cardiology, Temple University Hospital, 9th floor Parkinson Pavilion, 3401 North Broad Street, Philadelphia, PA 19140, USA.
² Pulmonary and Critical Care, Temple University Hospital.
³ Pulmonary Hypertension, Right Heart Failure, CTEPH Program, Division of Cardiology, Temple University Hospital, 9th floor Parkinson Pavilion, 3401 North Broad Street, Philadelphia, PA 19140, USA. Electronic address: [email protected].

PMID: 37973349
DOI: 10.1016/j.ccc.2023.05.003

Abstract

Pulmonary hypertension (PH) encompasses a broad range of conditions, including pulmonary artery hypertension, left-sided heart disease, and pulmonary and thromboembolic disorders. Successful diagnosis and management rely on an integrated clinical assessment of the patient's physiology and right heart function. Right ventricular (RV) heart failure is often a result of PH, but may result from varying abnormalities in preload, afterload, and intrinsic myocardial dysfunction, which require distinct management strategies. Consideration of an individual's hemodynamic phenotype and physiologic circumstances is paramount in management of PH and RV failure, particularly when there is clinical instability in the intensive care setting.

Keywords: Critical care; Hemodynamics; Pulmonary hypertension; Right heart physiology; Right ventricular failure.

Publication types

Review

MeSH terms

Critical Care
Heart Failure* / complications
Heart Failure* / diagnosis
Heart Failure* / therapy
Hemodynamics / physiology
Humans
Hypertension, Pulmonary* / diagnosis
Hypertension, Pulmonary* / therapy
Intensive Care Units
Ventricular Dysfunction, Right* / diagnosis
Ventricular Dysfunction, Right* / therapy