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Pressure overload may affect any of the four chambers of the heart, though the term is most commonly applied to one of the two ventricles. Chronic pressure overload leads to concentric hypertrophy of the cardiac muscle, which can in turn lead to heart failure, myocardial ischaemia or, in extreme cases, outflow obstruction. [1]
Right ventricular hypertrophy is the intermediate stage between increased right ventricular pressure (in the early stages) and right ventricle failure (in the later stages). [11] As such, management of right ventricular hypertrophy is about either preventing the development of right ventricular hypertrophy in the first place, or preventing the ...
The pathophysiology of pulmonary heart disease (cor pulmonale) has always indicated that an increase in right ventricular afterload causes RV failure (pulmonary vasoconstriction, anatomic disruption/pulmonary vascular bed and increased blood viscosity are usually involved [1]), however most of the time, the right ventricle adjusts to an overload in chronic pressure.
Rhythmicity and contractility of the heart may be normal, but the stiff walls of the heart chambers (atria and ventricles) keep them from adequately filling, reducing preload and end-diastolic volume. Thus, blood flow is reduced, and blood volume that would normally enter the heart is backed up in the circulatory system.
As such, the right ventricle cannot cope as well with higher pressures, and although right ventricular adaptations (hypertrophy and increased contractility of the heart muscle) initially help to preserve stroke volume, ultimately these compensatory mechanisms are insufficient; the right ventricular muscle cannot get enough oxygen to meet its ...
Pathologic pressure mismatches between the pulmonary and systemic circulation guide compensatory remodeling of the left and right ventricles. The term "reverse remodeling" in cardiology implies an improvement in ventricular mechanics and function following a remote injury or pathological process. [3] [4] [5]
PAH is definitively diagnosed with a right heart catheterization showing a mean pulmonary arterial pressure greater than 20 mmHg at rest, with a pulmonary vascular resistance being 3 Woods Units or greater (indicative of pulmonary hypertension in the pre-capillary vasculature; the arteries and arterioles), and a pulmonary artery wedge pressure ...
Right heart failure was thought to compromise blood flow to the lungs compared to left heart failure compromising blood flow to the aorta and consequently to the brain and the remainder of the body's systemic circulation. However, mixed presentations are common, and left heart failure is a common cause of right heart failure. [59]
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