Acute Right Heart Failure

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Authors: Angus Perks, William Kenworthy / Editors: Frances Balmer / Codes: / Published: 12/02/2024

Right heart failure (RHF) is an under-recognised syndrome that carries a high mortality. Patients can deteriorate rapidly and crucially, commonly initial treatments for critically unwell patients such as intravenous (IV) fluids and intubation are often harmful, precipitating cardiovascular collapse and cardiac arrest.

As such, prompt recognition and targeted management of RHF is essential in the Emergency Department (ED).

This learning session focuses on the understanding, recognition and management of acute RHF.

Learning objectives

After completing this session, you will be able to:

  • Understand normal right ventricular physiology, anatomy & pathophysiology of failure
  • Promptly identify RHF in the ED
  • Formulate a differential diagnosis of causes
  • Appreciate why common interventions such as IV fluids and intubation can cause cardiovascular collapse in right heart dysfunction
  • Understand the vicious cycle of acute RHF and steps to break it
  • Effectively resuscitate patients in acute RHF


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