ABSTRACT
In recent years, more and more attention has been paid to the evaluation and management of right heart function, for which point-of-care unltrasound provides more opportunities. A patient with acute right heart failure after tricuspid valve replacement was successfully treated in department of critical care medicine of Wuxi People's Hospital Affiliated to Nanjing Medical University. This patient showed typical manifestations of acute right heart failure by point-of-care ultrasound. The overall right ventricular systolic function was weakened, and the right ventricle was enlarged. Ratio of the diameter for right ventricle to left ventricle was greater than 1. In the parasternal short-axis view, the right ventricle was oval, and ventricular septum was convex to the left ventricle. The preload of left ventricular was low and the left ventricular diastolic function was limited. Under the guidance of point-of-care ultrasound, the patient's condition tended to improve after treatments such as strengthening the heart, adjusting the preload and afterload of the left and right ventricles, improving renal blood perfusion, and respiratory support. The right ventricle was smaller than before, the systolic function of right ventricle and diastolic function of left ventricle were improved. The successful treatment experience of this case is summarized for reference.
ABSTRACT
A 75-year-old woman presented with dyspnea, and was admitted urgently on a diagnosis of concurrent acute cardiac insufficiency. Because of her low blood pressure and respiratory failure, care was started in the intensive care unit. A transthoracic echocardiogram (TTE) showed severe tricuspid regurgitation (TR). We concluded that her cardiogenic shock was caused by acute right heart failure with severe TR and therefore carried out emergency surgery. We noted expansion of the tricuspid valve ring and shortening of the tendinous cord, and the leaflet was pulled into the right ventricle side. Initially we attempted a tricuspid annuloplasty (TAP), but it proved difficult to control the TR. We therefore performed a tricuspid valve replacement (TVR). The patient was moved from the intensive care unit to a general ward 10 days after the operation, and to another hospital 26 days later.
ABSTRACT
Objective To investigate the nalaxone treating first acute right heart failure.Methods52 patients with FARHF were divided into the naloxone group(30cases)and control group(20cases)at random.Patients in control group were given general comprehensively treating.Patients in naloxone group were given naloxone as well as comprehensively treating,were given intravenously 0.8 mg of first dose,if it was necessary,repeated 0.8 mg of dose,and continuously dropped for 1.2 mg was added into liquid 500 mL.After treatment of 24 hours,were compared the changes of HR、SBP、SV and heart function.ResultsIn the naloxone group,the total effective rates were 84.4%,the mortality rates were 6.6%;in control group.The total effective rates were 60%,the mortality rates were 18.3%.The difference of the effective rate of the naloxone group be treatment was statistically significant(P