Right Ventricular Failure

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Ryan Tedford about right ventricular failure, a condition often underdiagnosed and mismanaged in critically ill patients. Dr. Tedford provides a historical context, explaining the initial disregard for the right ventricle's importance and why it should be a focus for critical care clinicians today. The discussion covers the hemodynamic determinants of right ventricular function, cellular and molecular mechanisms, and diagnostic and evaluation methods, including echocardiography and right heart catheterization. They explore the causes of right ventricular failure through the framework of preload, afterload, and contractility, and delve into treatment options such as preload optimization, contractility augmentation, afterload reduction, inhaled vasodilators, catheter-directed therapies for pulmonary embolism, and mechanical support. The episode concludes with Dr. Tedford sharing book recommendations and insights on medicine and patient care.