[Treatment of cardiogenic shock due to right ventricular involvement].
Luis Efren Santos-MartínezGian Manuel Jiménez-RodríguezJorge Sánchez-NietoSergio Ortiz-ObregónDiana Romero-ZertucheLuis-Antonio Moreno-RuizPublished in: Revista medica del Instituto Mexicano del Seguro Social (2023)
The right ventricle is susceptible to changes in preload, afterload, and contractility. The answer is its dilation with dysfunction/acute failure; filling is limited to the left ventricle and cardiac output. Systemic venous congestion is retrograde to the right heart, it is involved in the genesis of cardiogenic shock due to right ventricle involvement. This form of shock is less well known than that which occurs due to left ventricular failure, therefore, treatment may differ. Once the primary treatment has been carried out, since no response is obtained, supportive treatment aimed at ventricular pathophysiology will be the next option. It is suggested to evaluate the preload for the reasoned indication of liquids, diuretics or even ultrafiltration. Restore or maintain heart rate and sinus rhythm, treat symptomatic bradycardia, arrhythmias that make patients unstable, use of temporary pacing or cardioversion procedures. Improving contractility and vasomotility, using vasopressors and inotropes, alone or in combination, the objective will be to improve right coronary perfusion pressure. Balance the effect of drugs and maneuvers on preload and/or afterload, such as mechanical ventilation, atrial septostomy and pulmonary vasodilators. And the increasing utility of mechanical support of the circulation that has become a useful tool to preserve/restore right heart function.
Keyphrases
- heart rate
- left ventricular
- pulmonary hypertension
- mechanical ventilation
- atrial fibrillation
- heart failure
- end stage renal disease
- pulmonary artery
- mitral valve
- chronic kidney disease
- coronary artery disease
- acute respiratory distress syndrome
- coronary artery
- magnetic resonance imaging
- combination therapy
- magnetic resonance
- oxidative stress
- acute myocardial infarction
- heart rate variability
- liver failure
- percutaneous coronary intervention
- acute coronary syndrome
- drug induced
- pulmonary arterial hypertension
- prognostic factors
- smooth muscle