Acute right heart syndrome in the critically ill patient

Acute right heart syndrome is a sudden deterioration in right ventricular performance, resulting in right ventricular failure and confers significant in-hospital morbidity and mortality. In critically ill patients, the syndrome is often undiagnosed and untreated, as these patients do not usually exhibit the common clinical manifestations of the condition, making the diagnosis challenging for the intensivist. In this narrative review we focus on the pathophysiology of acute right heart syndrome, in critical illness, diagnostic modalities used to assess right ventricular function and management of acute right heart syndrome, including mechanical ventilation strategies and circulatory support.