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Right Sided Heart Failure
Right Sided Heart Failure81104
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MEDICAL ANIMATION TRANSCRIPT: In right-sided heart failure, the right ventricle cannot contract with enough force to push de-oxygenated blood, a volume called preload, out of the heart, through the pulmonary arteries and into the lungs for oxygenation. The most common cause of right-sided heart failure is left-sided heart failure, often the result of coronary artery disease. Increased after-load or resistance in pulmonary arteries elevates pumping pressure and weakens the right ventricle overtime. Right-sided heart failure caused by pulmonary disorders is called cor pulmonale. Pulmonary conditions that contribute to right-sided heart failure are chronic obstructive pulmonary disease, or COPD, cystic fibrosis, and acute respiratory distress syndrome, or ARDS. As the overworked right ventricle labors to get the blood into the normally low-pressure pulmonary arterial system, its walls hypertrophy and pump ineffectively. Ineffective pumping causes blood to remain in the right ventricle and atrium, increasing pressure inside the right side of the heart and pulmonary arteries, forcing the right ventricle to work harder to overcome the resistance. The heart muscle hypertrophies and pumps ineffectively resulting in the insufficient delivery of nutrients and oxygen to the heart and other vital tissues. Blood accumulating in the right ventricle and atrium congests the venous circulation including the vena cavae, jugular veins, and portal circulation. Buildup blood and fluid in the liver's tissues leads to hepatomegaly. Reduced cardiac output deprives the kidneys of blood, impairing filtration and their ability to remove excess sodium and water. Nocturia, or excessive urination at night, often reflects the renal impairment secondary to right-sided heart failure. Retained sodium and water increase the blood volume pump by the overloaded heart, raising vascular pressure and increasing resistance against which the heart must pump. In response to venous congestion, fluid collects in the skin and soft tissues, causing a condition called peripheral edema and in the abdomen causing a condition known as ascites. Treatment for heart failure involves changes in lifestyle such as diet and exercise, medication, surgery, or a combination of approaches. Commonly, medications for right-sided heart failure are geared toward improving left-sided cardiac function. Medications commonly prescribed for a heart failure include diuretics, which reduce fluid volume and venous return by inhibiting sodium and water reabsorption along the kidney's renal tubular system. ACE inhibitors, which block hormones in the renin-angiotensin-aldosterone system, dilating vessels, lowering blood volume and venous return, decreasing the heart's workload and halting ventricular hypertrophy. Digoxin, a medication that increases the force of myocardial contractility by raising intracellular sodium and calcium concentrations. And beta-blockers, which compete with norepinephrine molecules for binding sites on cardiomyocytes preventing norepinephrine's effects, resulting in reduced speed and strength of the contractions which can support more efficient circulation through the body. ♪ [music] ♪

ANM10006 04:43

Last Updated: Apr 24th, 2020

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