Transthoracic Right Heart Echocardiography for the Intensivist. [Review]

MedStar author(s):
Citation: Journal of Intensive Care Medicine. 36(9):1098-1109, 2021 Sep.PMID: 33853435Institution: MedStar Washington Hospital CenterDepartment: Emergency Medicine | Surgery/Surgical Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Hypertension, Pulmonary | *Ventricular Dysfunction, Right | Echocardiography | Heart Ventricles | Humans | Ventricular Dysfunction, Right/dg [Diagnostic Imaging] | Ventricular Function, RightYear: 2021ISSN:
  • 0885-0666
Name of journal: Journal of intensive care medicineAbstract: BACKGROUND: The impact of critical illness on the right ventricle (RV) can be profound and RV dysfunction is associated with mortality. Intensivists are becoming more facile with bedside echocardiography, however, pedagogy has largely focused on left ventricular function. Here we review measurements of right heart function by way of echocardiographic modalities and list clinical scenarios where the RV dysfunction is a salient feature.CONCLUSION: The right ventricle is impacted by various critical illnesses with substantial mortality and mortality. Focused bedside echocardiographic exams with attention to the right heart may provide intensivists insight into RV function and provide guidance for patient management.MAIN: RV dysfunction is heterogeneously defined across many domains and its diagnosis is not always clinically apparent. The RV is affected by conditions commonly seen in the ICU such as acute respiratory distress syndrome, pulmonary embolism, RV ischemia, and pulmonary hypertension. Basic ultrasonographic modalities such as 2D imaging, M-mode, tissue Doppler, pulsed-wave Doppler, and continuous Doppler provide clinicians with metrics to assess RV function and response to therapy.All authors: Dugar S, Haycock K, Hockstein MA, Lentz S, Siuba M, Wiepking MOriginally published: Journal of Intensive Care Medicine. :8850666211003475, 2021 Apr 15Fiscal year: FY2022Fiscal year of original publication: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2021-06-07
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Journal Article MedStar Authors Catalog Article 33853435 Available 33853435

BACKGROUND: The impact of critical illness on the right ventricle (RV) can be profound and RV dysfunction is associated with mortality. Intensivists are becoming more facile with bedside echocardiography, however, pedagogy has largely focused on left ventricular function. Here we review measurements of right heart function by way of echocardiographic modalities and list clinical scenarios where the RV dysfunction is a salient feature.

CONCLUSION: The right ventricle is impacted by various critical illnesses with substantial mortality and mortality. Focused bedside echocardiographic exams with attention to the right heart may provide intensivists insight into RV function and provide guidance for patient management.

MAIN: RV dysfunction is heterogeneously defined across many domains and its diagnosis is not always clinically apparent. The RV is affected by conditions commonly seen in the ICU such as acute respiratory distress syndrome, pulmonary embolism, RV ischemia, and pulmonary hypertension. Basic ultrasonographic modalities such as 2D imaging, M-mode, tissue Doppler, pulsed-wave Doppler, and continuous Doppler provide clinicians with metrics to assess RV function and response to therapy.

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