Right ventricular dysfunction

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Right ventricular dysfunction usually results from either pressure overload, volume overload, or a combination.

It occurs in a number of clinical scenarios, including:

It can manifest as right heart strain.

Pathology

Sustained right ventricular dilatation and hypertrophy can frequently progress to right ventricular failure.

Radiographic features

Echocardiography

Two dimensional echocardiography is usually considered the mainstay for analysis of right ventricular function.

Features include

  • right ventricular wall can be thickened (>4 mm) (often observed in congenital heart disease) or dilated (in acquired heart disease)
  • free wall may be hypokinetic; this is best appreciated on parasternal long axis projections
CT

May have a role in assessment. Suggestive signs include:

  • right ventricular dilatation (RVD) (RV/LV ratio, >0.9)
Cardiac MRI

Several phenotypic patterns have been described .

  • pressure overload
  • volume overload
  • volume overload plus left ventricular dysfunction: considered 2commonest pattern
  • depressed biventricular function: commonest pattern
  • mixed overload, as there is co-existing biventricular dysfunction (in different degrees depending on disease duration), dilatation and right ventricular hypertrophy

    • See also