Clinical Edge

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AHA: Management of Right-Sided Heart Failure

Circulation; ePub 2018 Apr 12; Konstam, et al

The American Heart Association (AHA) has issued a scientific statement providing guidance on the assessment and management of right-sided heart failure (RHF). The statement reviews the causes and epidemiology of right ventricular (RV) dysfunction and the pathophysiology of acute and chronic RHF to provide guidance for the management of the associated conditions leading to and caused by RHF. Among the findings and conclusions:

  • Chronic RHF is associated with decreased exercise tolerance, poor functional capacity, decreased cardiac output, and progressive end-organ damage, as well as a systemic proinflammatory state.
  • It is the principal cause of death in patients with pulmonary arterial hypertension.
  • Volume management is paramount in the care of patients with acute RHF.
  • Magnetic resonance imaging is currently the gold standard for measurements of volume, mass, and systolic function.
  • The cornerstone of management of chronic RHF consists of volume management with oral diuretics.

Citation:

Konstam MA, Kiernan MS, Bernstein D, et al. Evaluation and management of right-sided heart failure. A scientific statement from the American Heart Association. [Published online ahead of print April 12, 2018]. Circulation. doi:10.1161/CIR.0000000000000560.