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The Acutely Decompensated Right Ventricle*: Pathways for Diagnosis and Management

Gregory Piazza, MD; Samuel Z. Goldhaber, MD, FCCP
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*From the Department of Internal Medicine, Beth Israel Deaconess Medical Center (Dr. Piazza), Boston, MA; and Cardiovascular Division (Dr. Goldhaber), Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.

Correspondence to: Samuel Z. Goldhaber, MD, FCCP, Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115; e-mail: sgoldhaber@partners.org



Chest. 2005;128(3):1836-1852. doi:10.1378/chest.128.3.1836
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Decompensated right ventricular (RV) failure is becoming increasingly common as the prevalence of predisposing conditions grows. Advances in diagnosis and management have granted insights into the following pathophysiologic mechanisms of RV dysfunction: impaired RV contractility, RV pressure overload, and RV volume overload. Emerging imaging modalities, such as cardiac MRI, and new therapeutic agents, such as pulmonary selective vasodilators, have expanded our options for evaluation and management, respectively. An improved understanding of pathophysiology and technologic progress provides us with new pathways in the diagnosis and hemodynamic support of these often critically ill patients.

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