Acute Right Heart Failure Management Case 1 

An 89-year-old male with PMH of CKD 4 and LHF presents with abdominal discomfort and leg swelling two weeks after an admission for AKI, at which time his furosemide was stopped.

His echo from six months ago showed LVEF 40% and normal RV size and function.

His observations are SpO2 93% on room air, HR 120 sinus rhythm, BP 101/46, RR 28.

Examination reveals a clear chest, warm peripheries and pitting oedema to his mid-abdomen. Bloods show lactate 4, creatinine 360 (previously 180), and pCO2 3.9kPa.