This article is part of the supplement: A reappraisal for the use of pulmonary artery catheters .

Review

What role does the right side of the heart play in circulation?

Maurizio Cecconi^1,2, Edward Johnston³ and Andrew Rhodes¹

¹Department of Intensive Care, St. George's Hospital, London, UK

²Scuola di Anestesia e Rianimazione, University of Studies, Udine, Italy

³Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK

author email corresponding author email

Critical Care 2006, 10(Suppl 3):S5doi:10.1186/cc4832

Published:	27 November 2006

Abstract

Right ventricular failure (RVF) is an underestimated problem in intensive care. This review explores the physiology and pathophysiology of right ventricular function and the pulmonary circulation. When RVF is secondary to an acute increase in afterload, the picture is one of acute cor pulmonale, as occurs in the context of acute respiratory distress syndrome, pulmonary embolism and sepsis. RVF can also be caused by right myocardial dysfunction. Pulmonary arterial catheterization and echocardiography are discussed in terms of their roles in diagnosis and treatment. Treatments include options to reduce right ventricular afterload, specific pulmonary vasodilators and inotropes.