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Review
. 2025 Jul 27;15(8):1194.
doi: 10.3390/life15081194.

Right Heart Evaluation: A Tough Challenge for Clinicians

Martina Pucci  1 , Luca Maria Capece  1 , Mariateresa Pontoriero  1 , Daniele Paoletta  1 , Marina Iacono  1 , Francesca La Rocca  2 , Roberto Luise  1 , Roberta Esposito  1
Affiliations
Review

Right Heart Evaluation: A Tough Challenge for Clinicians

Martina Pucci et al. Life (Basel). .

Abstract

The right heart-pulmonary circulation unit (RH-PCU) constitutes an integrated anatomo-functional system characterized by high-volume blood flow, low intravascular pressure, and minimal pulmonary vascular resistance. The RH-PCU dysfunction is a challenge for clinicians, as it can result from numerous pathological conditions, each with different clinical presentations. The pathophysiological changes underlying the hemodynamic alterations in the pressure and volume affecting the right ventricle can lead the patient to present with the primary symptom: dyspnea. We review the clinical presentation, the laboratory test, and the role of multimodality imaging in the evaluation of the disfunction of the RHPCU, including echocardiography, stress echocardiography, computed tomography, magnetic resonance imaging, nuclear imaging, and invasive pressure measurement through catheterization. We therefore aimed to describe the various diagnostic options available to clinicians, evaluating their effectiveness and limitations of use.

Keywords: dyspnea; echocardiography; right ventricle.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Right ventricular dysfunction physiopathology.
Figure 2
Figure 2
(A) Alterations of RH-PCU clinical symptoms. (B) Alterations of RH-PCU clinical signs. (C) RH-PCU diagnostic algorithm laboratory tests. (D) RH-PCU ECG abnormalities. (E) RH-PCU Chest RX Findings.
Figure 2
Figure 2
(A) Alterations of RH-PCU clinical symptoms. (B) Alterations of RH-PCU clinical signs. (C) RH-PCU diagnostic algorithm laboratory tests. (D) RH-PCU ECG abnormalities. (E) RH-PCU Chest RX Findings.
Figure 3
Figure 3
RH-PCU imaging tools.
Figure 4
Figure 4
Clinical case description of patients with dyspnea. (A) TR Velocity at rest; (B) TR Velocity during stress echo.
Figure 5
Figure 5
RH-PCU advanced imaging tools.
Figure 6
Figure 6
RH-PCU diagnostic algorithm.
See this image and copyright information in PMC

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