Peer Reviewed
Feature Article Cardiovascular medicine

Management of right heart failure

David Prior
Symptoms and signs suggestive of right heart failure may cause patients to present to their GP. Establishing the correct diagnosis through appropriate investigation will enable the most appropriate and effective treatment to be delivered. Aims of treatment include improving prognosis and relieving symptoms.
Key Points
  • Symptoms of right heart failure (RHF) are nonspecific and may also result from a variety of noncardiac diseases.
  • Accurate diagnosis of the underlying cause is the key to deciding on appropriate management. This always involves an echocardiographic assessment of cardiac function.
  • Diuretics are required in most cases of RHF to control fluid retention.
  • Nonpharmacological measures, including patient self-management, treatment of comorbidities and lifestyle changes, are important in the management of RHF.
  • A number of conditions causing RHF may be effectively treated with cardiac surgery and are therefore important to identify.
  • Patients with complex causes of RHF or taking multiple diuretics should be managed in conjunction with a cardiologist.
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