Right Heart Disease

What does RV afterload stress lead to?

-RV dysfunction -RV dilatation -RV to LV disproportion

What disease processes can effect RV function?

-RV infarction -cardiomyopathy involvement -secondary to increased pulmonary pressures -secondary to pulmonary embolism -congenital heart disease

What can an acute pulmonary embolism lead to?

-cor pulmonale -acute RHF -total cardiovascular collapse

What does the right heart do in response to pulmonary embolism?

-dilated RV in response to increased afterload -RV hypokinesis -increased RV pressure

What are the 4 muscular bands of the right ventricle?

-parietal band -crista supraventricularis -septal band -moderator band

The right ventricle is better at compensating for (pressure/volume) overload.

Volume.

What is an abnormal thickness for the walls of the right ventricle?

Greater than 5mm.

What can happen in the right heart that may lead to underfilling of the left ventricle?

Marked RV dilatation.

What is the right hearts reaction to increased pressure and volume?

Marked hypertrophy.

What is the McConnell sign?

Mild to moderate hypokinesis of free wall prox and mid segments. No apex.

Which vessel primarily supplies blood flow to the right ventricle?

Right coronary artery.

How does the thickness of the right heart compare to that of the left?

Right heart is 1/3rd the thickness of the left heart.

What is often the cause of pulmonary embolism?

Right heart thrombi or thrombi in transit.

What is the best window for evaluating RVH?

Subcostal 4 chamber.

What can help compensate for significant RV dysfunction?

The interventricular septum.

What is the right hearts reaction to volume overload?

To become hyperdynamic and mildly hypertrophic.

Severity of RHF depends on severity of obstruction. True or false?

True.

The right ventricle wraps around the left ventricle. True or False?

True.

Untreated severe MR can lead to pulmonary hypertension. True or False?

True.

About one third of _______ are accompanied by RV infarction.

Inferior wall infarcts.

When would you see paradoxical septal motion?

In cases of RVH.

What is a normal thickness for the walls of the right ventricle?

Less than 5mm.

The right heart is a (high/low) pressure system?

Low.

What is cor pulmonale?

Primary lung disease along with longstanding PHTN that leads to right heart failure.

When do symptoms of right heart failure occur more rapidly?

When the IVS is not working properly.

What is paradoxical septal motion?

When the septum moves away from the LV free wall during systole.

When does septal flattening occur?

When there is increased pressure or volume in the right heart.