Successful treatment of acute right heart failure under the guidance of point-of-care ultrasound: a case report / 中华危重病急救医学

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.