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Related Concept Videos

Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
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Related Experiment Video

Updated: Dec 5, 2025

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
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Right Ventricular Dysfunction in Early Sepsis and Septic Shock.

Michael J Lanspa1, Meghan M Cirulis2, Brandon M Wiley3

  • 1Critical Care Echocardiography Service, Intermountain Medical Center, St, Murray, UT; Division of Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT.

Chest
|October 17, 2020
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Right ventricular dysfunction is common in sepsis, affecting nearly half of patients. This condition significantly increases the risk of death within 28 days, highlighting its importance in sepsis management.

Keywords:
echocardiographypreloadright ventricleseptic cardiomyopathy

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Pulmonology

Background:

  • Sepsis is a life-threatening condition often linked to left ventricular (LV) dysfunction.
  • Right ventricular (RV) dysfunction in sepsis is less understood but potentially significant.

Purpose of the Study:

  • To determine the prevalence of RV dysfunction in critically ill septic patients.
  • To investigate the association between RV dysfunction and 28-day mortality in sepsis.

Main Methods:

  • Echocardiographic parameters were measured in 393 severe sepsis or septic shock patients within 24 hours of ICU admission.
  • RV dysfunction defined by fractional area change (FAC < 35%) or tricuspid annulus systolic plane excursion (TAPSE < 1.6 cm).
  • Logistic regression analyzed the relationship between RV/LV dysfunction and 28-day mortality, controlling for clinical factors and APACHE II score.

Main Results:

  • RV dysfunction was present in 48% of patients; LV systolic dysfunction in 63%.
  • Patients with RV dysfunction had significantly higher 28-day mortality (31% vs. 16%, P = .001).
  • RV dysfunction independently predicted increased mortality (OR, 3.4; P = .001), while LV dysfunction did not (OR, 0.63; P = .32).

Conclusions:

  • Right ventricular dysfunction is highly prevalent in severe sepsis and septic shock.
  • RV dysfunction is a significant independent predictor of increased 28-day mortality in septic patients.
  • Echocardiographic assessment of RV function is crucial for risk stratification in sepsis.