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3 Cards in this Set
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Occurs when right ventricle cannot effectively pump venous blood into the lungs
Cause increase in hydrostatic venous pressure
Pooling of blood in right atrium- increased pressure in right atrium - increased pressure in superior and inferior Vena cava - accumulation of blood in hepatic vein causing congestion in liver and other organs
Pathogenesis
Increased pressure in pulmonary vasculature eg pulmonary artery hypertension or pulmonary artery stenosis or left heart failure or saddle embolus - Increased resistance to blood flow out of right ventricle - increase in ventricular after load -
Decrease in right ventricular contraction eg right ventricular infarction, myocarditis
Non compliance of right ventricle- not filling properly eg restrictive cardiomyopathy, concentric right ventricular hypertrophy
Increase in right ventricular preload eg valve regurgitation or Left to right shunts
Most common cause Is left heart failure |
Clinical features and laboratory findings
Distention of internal jugular veins- due to increased volume of blood in the venous system behind failed right ventricle
Tricuspid valve regurgitation due to stretching of tricuspid valve ring from right ventricle volume overload
Right sided S3, S4 heart sounds due to volume overload of right ventricle
Painful hepatomegaly due to centrilobular hemorrhagic necrosis (venous blood backs up into hepatic vein, expansion of Centra venules, causing expansion of central venules, hepatic cell necrosis in zone III)
Increase in serum transaminase AST, ALT
Portal venous hypertension due to increase in pressure in sinusoids. This causes ascites
Compression of congested liver ( hepatojugular reflex) due to jugular vein distention
Dependent pitting edema due to increased venous hydrostatic pressure more in lower extremities
Cyanosis of mucus membranes- more in right sided heart failure than left heart failure
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