Diagnosis and treatment of urgent right bility

The article is consulted professionally by Master, Dr Vu Thi Tuyet Mai – Cardiologist – Cardiologist – Share99 Central Park International Health Hub.

Emergency right atatric failure is a complex syndrome, accounting for about 3-9% of patients admitted to the hospital due to heart failure and accounting for 5-17% of the cause of death among hospitalized patients.

1. What is urgent right atath?

The right cardiac cardiac is triangular, structured with 3 parts: the receiving chamber, the beak and the funnel. The center is composed of a mechanical fiber system intertwined in three dimensions. Acute right fission is a clinical syndrome, characterized by a state of right unemployment that is incapable of providing sufficient blood flow to the pulmonary circulation under normal central system vein pressure conditions. The consequence of the disease is the dilion of the right ovarian chamber and the opening of the tri-leaf valve.

Causes of urgent right failure include:

● Extensive pulmonary infarction;

● Acute pulmonary vascular pressure increase;

Acute respiratory distress syndrome (ARDS);

Right right right cardicardiary infarction on ECG;

Infections and cardicardiosis caused by infections;

● Mechanical breathing;

● After cardi lung transplant surgery;

● After placing the left loss support tools;


● Acute episodes on the right dilary background have suffered chronic damage (increased acute pulmonary artery pressure, right dil dilated, right otitis hypertrocent).

2. Method of diagnosis of urgent right ather failure

2.1 Diagnosis through clinical symptoms

Symptoms of right-to-be-issued atath include:

● Manifestations of vein stagnation and fluid retention

Lack of oxygen

● Varicose veins of the neck, liver feedback – vein

● Peripheral edema, spleen liver due to condural, pericardous effusion, pericardous effusion,body edema;

● T3, the sound of open tri-leaf valves, heart liver, signs of combined left atrial disorders;

● Inverse circuit

● Ventilator/PEEP pressure drop

● Pressure drops that do not respond to infusions

Tachycardia,cold genuss, oliguria, central nervous system abnormalities;

Liver failure, renal failure.

2.2 Cardiac ultrasound

The goal of cardiac ultrasound is to exclude the external cause of acute right fibrillation that needs urgent treatment such as acute cardiac compression, while evaluatibing right atrium pressure, evaluatiy sysotose pulmonary artery pressure, evaluatiy total right atrial function. In addition, cardiac ultrasound is also used to assess the tension of the wall of the cardiac wall (the shortitudinal contraction of the region and the entire right right atathinal).


Cardiac ultrasound to diagnose urgent right aural failure

2.3 Evaluation of hemolysis by pulmonary artery catheter

This is an invasive diagnostic method, recommended for cases of unemployment that must be of unknown or non-therapeutic response. The pulmonary artery catheter evaluation method provides accurate and continuous information about left atrial, right atrial, cardiac output and pulmonary capillary resistance. However, this is an invasive method, so it is usually in place only in some complex cases.

3. Treatment of urgent right bility

The treatment of unemployment must be urgently required to coordinate many specialties. The treatment of the disease also varies depending on the clinical signs: Treatment of the consequences of right ventilated failure, remission of symptoms(shortnessof breath, pain) and psychological treatment of the patient.

3.1 Treatment of right-level unemployment

Evaluation of diseasesevereness: Includes clinical evaluation (neurological signs, arterial blood pressure, diuretic), photo (cardiac ultrasound, CT scan),bio chemical test evaluation (lactate, liver marquer, BNP, renal function, troponin) and intrusive test (central vein catheter, pulmonary artery catheter

Identify therapeutic factors: Sepsis, arrhythmias,discontinuation of medications. At the same time, treatment of specialized causes such as coronary intervention for right venerated myocardial infarction, re-perfusion for cases of high-risk pulmonary embolism

Optimize the amount of volume of waterin the body: Intravenous diabetes (if the volume overload is overloaded), renal replacement (if the patient does not respond to diuretic), carefully compensate if the central vein pressure is low, avoid epidemic overload.

Maintenance of arterial blood pressure:Use Norepinephrine;

● Consider using vascular medications that reduce heart filling pressure: Including Levosimendan, Dobutamine and phosphodiesterase inhibitors;

● Apply other methods of post-load reduction: Inhaled Prostacyclin, NO inhalation.

3.2 Treatment of urgent right bility

Optimize volume of volume: The amount of water inserted into the patient's body can cause right cardiac isaction overload, increase heart tension, reduce spasms, make the three-leaf valve opening heavier, increase the effect on the correlation of 2 cardiac, reduce left atrial fibrillation and, as a result, reduce heart supply. Therefore, it is necessary to bring the solution into the patient's body with caution under the monitoring of central vein pressure (CVP) in case the filling pressure does not increase and low arterial pressure is a coordinated factor that causes right atath stairs;

Weuresis: When right fission worsens, the weuretic is the first treatment option in parallel with maintaining arterial pressure for most patients with signs of intravenous hemolysis. Treatment of weure helps to redistrim the epidemic in the vein system, thereby quickly improving clinical symptoms. The monitoring of urine volume, adjustment of weeds is carried out in accordance with the treatment regimen;

Treatment of vascular medications and antisyms: In case of atathinal failure there must be hemolytic disorders. The use of these drugs should be in accordance with the treatment regimen. Some commonly prescribed medications include:

○ Noradrenalin: Restores blood pressure, increases cerebral perfusion, coronary and other muscles. This drug can improve the hemolysis of the system;

○ Dobutamin, Levosimendan and phosphodiesterase III inhibitors: Increased contraction and increased cardiac output. However, these medications can aggravate hypotension, so it may be necessary to coordinate with Noradrenalin.


Heart transplantation is one of the treatments for urgent right athcardia

● Mechanical equipment supporting the re-30th:

○ Acute mechanical ventilation: In place in cases such as right venerthal infarction, acute pulmonary embolism, post-heart transplant failure, or after using a left veneerator;

○ External Membrane Oxidizing Machine/Life Support Equipment (ECMO/ECLS): Provides oxygen quickly in a short time. However, after 5-10 days it is recommended to change the ECMO or change to an intermediate or long-term instrument to avoid complications caused by ECMO such as infection, thromboembolic formation around the cathethetics, local infection or decreased perfusation of the 3 nodes;

○ Right unemployment aid (RVADs): Can be inserted into the patient's body by skin transplantation or surgery, long-term use (4 weeks). These devices can also coordinate with oxygen machines as needed. However, using right nodes also carries a risk of bleeding complications or thromboembolysis;

Hearttransplantation: Is the last treatment option in case of right atathcardia does not respond to the above treatments.

Urgent right atatric failure is a pathology with a high degree of danger and the treatment is relatively complex. Patients need early diagnosis and timely medical and interventional treatment, to reduce complications and improve mortality

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About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.


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