Acute right heart failure in patients with pulmonary hypertension

Abstract

The occurrence of acute right heart failure remains the most frequent cause of death in patients with pulmonary hypertension (PH). Management of acute right heart failure is based on treatment of triggering factors, fluid status optimization, strategies to improve cardiac function (inotropic agents, vasopressors) and to reduce right ventricular afterload. In case of refractory right heart failure despite maximal medical strategy, the use of mechanical support can be considered in selected candidates for lung transplantation. Management of such patients requires expert centers with multidisciplinary teams able to offer all modern treatment options combining implementation of novel medical, instrumental and surgical management of right heart failure.