The Right Ventricle in Cardiac Critical Care: Pathophysiology, Evaluation and Management.
A, B., I, A., E, K., SA, M., A, N., N, F., C, P., & V, V. (2026). The Right Ventricle in Cardiac Critical Care: Pathophysiology, Evaluation and Management.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina62061070
A B, I A, E K, SA M, A N, N F, et al. The Right Ventricle in Cardiac Critical Care: Pathophysiology, Evaluation and Management.. Medicina (Kaunas, Lithuania). 2026; doi: 10.3390/medicina62061070
A B, I A, E K, et al. The Right Ventricle in Cardiac Critical Care: Pathophysiology, Evaluation and Management.[J]. Medicina (Kaunas, Lithuania). 2026. DOI: 10.3390/medicina62061070.
@article{a2026,
author = {Boulmpou A and Alevroudis I and Karagiannidis E and Mouratoglou SA and Nasoufidou A and Fragakis N and Papadopoulos C and Vassilikos V},
title = {The Right Ventricle in Cardiac Critical Care: Pathophysiology, Evaluation and Management.},
journal = {Medicina (Kaunas, Lithuania)},
year = {2026},
doi = {10.3390/medicina62061070},
note = {PMID: 42356083},
}
TY - JOUR AU - Boulmpou A AU - Alevroudis I AU - Karagiannidis E AU - Mouratoglou SA AU - Nasoufidou A AU - Fragakis N AU - Papadopoulos C AU - Vassilikos V TI - The Right Ventricle in Cardiac Critical Care: Pathophysiology, Evaluation and Management. T2 - Medicina (Kaunas, Lithuania) PY - 2026 DO - 10.3390/medicina62061070 AN - PMID:42356083 ER -
The right ventricle (RV) is a primary determinant of outcomes in cardiac critical care. RV dysfunction independently predicts morbidity and mortality in conditions such as acute coronary syndromes, pulmonary embolism, and cardiogenic shock. This review synthesizes RV evaluation and management by integrating physiologic principles with bedside diagnostic and therapeutic strategies. The RV is exceptionally sensitive to acute afterload increases due to its adaptation to low-pressure pulmonary circulation. Evaluation utilizes a multimodal approach combining echocardiography, invasive hemodynamics, and specifically the pulmonary artery pulsatility index and central venous pressure/pulmonary capillary wedge pressure (CVP/PCWP) ratio and biomarkers. Management focuses on three pillars: individualized preload optimization, afterload reduction via selective pulmonary vasodilators, and contractility augmentation with inotropes. For refractory cases, mechanical circulatory support options like Impella RP, ProtekDuo, and VA-ECMO provide critical bridges to recovery or transplantation.