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The Right Heart

  • Dalia BanksEmail author
Chapter
  • 1.8k Downloads

Abstract

Historically, clinical and research efforts have primarily focused on the left ventricle. However, relatively recent identification that evidence of right heart dysfunction increases the perioperative morbidity and mortality of patients undergoing both cardiac and noncardiac surgery has brought the echocardiographic evaluation of the right heart into the spotlight. This chapter serves to identify the unique concerns when evaluating echocardiographically the complex geometry and physiology of the right heart as well as its unique adaptive properties in response to acute and chronic afterload increases. Both anatomical assessments and quantitative methods of evaluating right ventricular function will be discussed. Transesophageal echocardiography therefore plays a key role in the identification and management of those patients at risk for right heart dysfunction.

Keywords

Right ventricle Right atrium Pulmonary hypertension Pulmonary embolism Tricuspid regurgitation Pulmonary artery 

Supplementary material

Video 8.1

Midesophageal four-chamber view demonstrating severe right ventricular enlargement (AVI 13,180 KB)

Video 8.2

Midesophageal four-chamber view demonstrating severe right heart enlargement and a prominent moderator band (AVI 10,183 KB)

Video 8.3

Transgastric midpapillary short axis view in a patient with severe right ventricular enlargement and prominent interventricular septal shift. Note the “D-shaped” left ventricle (AVI 8,103 KB)

Video 8.4

Midesophageal four-chamber view demonstrating significant right atrial enlargement and interatrial septal shift toward the left atrium (MOV 1,477 KB)

Video 8.5

Color flow Doppler demonstrating a patent foramen ovale in a midesophageal bicaval view (AVI 2,940 KB)

Video 8.6

Color flow Doppler demonstrating severe tricuspid regurgitation in a midesophageal four-chamber view of a patient with a severely dilated right heart (MOV 1,511 KB)

Video 8.7

Midesophageal RV inflow–outflow view of a patient with a thrombus-in-transit identified during resuscitation for an acute pulmonary embolism (AVI 14,738 KB)

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of California San DiegoSan DiegoUSA

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