Santos MLE

Language: Spanish
References: 20
Page: 353-357
PDF size: 67.62 Kb.

ABSTRACT

Right ventricular failure may adversely influence the natural history and prognosis of patients with diverse cardiopulmonary disorders. The pathophysiologic mechanisms of right ventricular failure are analyzed, comparing normal condition to an acute and chronic pressure overload condition. Particular physiopathological features of these three different Cor pulmonale entities are made. In acute condition, pulmonary embolism is the most representative clinical condition of right ventricular failure. In chronic condition two diseases that produce pulmonary hypertension for different mechanisms are reviewed. In the chronic obstructive pulmonary disease where the abnormal pulmonary gas exchange is responsible for the pulmonary hypertension, the main clinical features are related to venous systemic congestion due to activation of the renin-angiotensin-aldosterone system and they considerably improve with the use of supplementary oxygen improving also the survival. Meanwhile, in the primary or idiopathic form, the vascular obstruction is the origin of the pulmonary hypertension, the manifestations of low cardiac output are predominant and the mechanism of right ventricular failure is not known in detail. During the lecture I will talk about the pathophysiological role of right ventricular ischemia, adrenergic over-stimulation and the genetic determination in the genesis of right ventricular failure and the impact of the atrioseptostomy in the improvement of the clinical manifestations and the hemodynamic parameters of right ventricular failure.

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