Levitt Catherine V, Williams Caitlin A, Ahari Jalil, Pourmand Ali
Department of Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
Pulmonary and Critical Care Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
J Clin Med. 2024 Feb 2;13(3):869. doi: 10.3390/jcm13030869.
Acute right heart failure (ARHF) arises when the right ventricle fails to pump blood efficiently to the pulmonary circulation. This inefficiency leads to a decreased blood supply to various organs. ARHF is a significant health concern, often leading to increased hospital admissions and being associated with a higher risk of mortality. This condition underscores the importance of effective cardiac care and timely intervention to manage its complications and improve patient outcomes. Diagnosing ARHF involves a comprehensive approach that includes a physical examination to evaluate the patient's fluid status and heart-lung function, blood tests to identify potential triggers and help forecast patient outcomes and various imaging techniques. These imaging techniques include electrocardiograms, point-of-care ultrasounds, computed tomography, cardiac magnetic resonance imaging, and other advanced monitoring methods. These diagnostic tools collectively aid in a detailed assessment of the patient's cardiac and pulmonary health, essential for effective management of ARHF. The management of ARHF focuses on addressing the underlying causes, regulating fluid balance, and enhancing cardiac function through pharmacological treatments or mechanical support aimed at boosting right heart performance. This management strategy includes the use of medications that modulate preload, afterload, and inotropy; vasopressors; anti-arrhythmic drugs; ensuring proper oxygenation and ventilation; and the utilization of heart and lung assist devices as a bridge to potential transplantation. This review article is dedicated to exploring the pathophysiology of ARHF, examining its associated morbidity and mortality, evaluating the various diagnostic tools available, and discussing the diverse treatment modalities. The article seeks to provide a comprehensive understanding of ARHF, its impact on health, and the current strategies for its management.
急性右心衰竭（ARHF）是指右心室无法有效地将血液泵入肺循环时发生的情况。这种低效导致各个器官的血液供应减少。ARHF是一个重大的健康问题，常常导致住院人数增加，并与更高的死亡风险相关。这种情况凸显了有效心脏护理和及时干预以管理其并发症并改善患者预后的重要性。诊断ARHF需要采取综合方法，包括体格检查以评估患者的液体状态和心肺功能、血液检查以识别潜在诱因并帮助预测患者预后，以及各种成像技术。这些成像技术包括心电图、即时超声、计算机断层扫描、心脏磁共振成像和其他先进的监测方法。这些诊断工具共同有助于对患者的心脏和肺部健康进行详细评估，这对于ARHF的有效管理至关重要。ARHF的管理重点在于解决潜在病因、调节液体平衡，并通过旨在增强右心功能的药物治疗或机械支持来改善心脏功能。这种管理策略包括使用调节前负荷、后负荷和心肌收缩力的药物；血管升压药；抗心律失常药物；确保适当的氧合和通气；以及利用心肺辅助装置作为潜在移植的桥梁。这篇综述文章致力于探讨ARHF的病理生理学，研究其相关的发病率和死亡率，评估现有的各种诊断工具，并讨论不同的治疗方式。文章旨在全面了解ARHF、其对健康的影响以及当前的管理策略。
