A novel case of transient right ventricular failure in a patient with respiratory distress

Stanley S. Liu, Lara C. Kovell, Aaron Horne, David Chang, John D. Petronis, Sammy Zakaria

Research output: Contribution to journalArticle

Abstract

Right ventricular (RV) failure is characterized by an inability to pump blood into the pulmonary circulation and can often lead to hemodynamic instability. Common causes of RV failure include left ventricular (LV) failure, RV infarction, sepsis, cor pulmonale due to acute respiratory distress syndrome, pulmonary emboli, or pulmonary hypertension. We report the case of a 61-year-old woman with no significant pulmonary or cardiac disease who presented with hypoxic respiratory failure in the setting of opioid overdose. She remained obtunded despite naloxone treatment and required endotracheal intubation as well as norepinephrine therapy for persistent hypotension. A transthoracic echocardiogram demonstrated isolated severe RV dysfunction without any LV abnormalities. Cardiac catheterization showed no obstructive coronary artery disease, pulmonary hypertension, or elevated left atrial pressures, and chest imaging only revealed signs of aspiration. Over the next 6 days, the patient's cardiac and respiratory function improved, and a repeat echocardiogram demonstrated complete normalization of RV function. This case demonstrates a novel finding that marked, but transient, RV dysfunction can occur in the setting of acute respiratory failure.

Original languageEnglish (US)
Pages (from-to)185-188
Number of pages4
JournalJournal of Intensive Care Medicine
Volume28
Issue number3
DOIs
StatePublished - May 2013

Fingerprint

Right Ventricular Dysfunction
Pulmonary Hypertension
Respiratory Insufficiency
Right Ventricular Function
Pulmonary Heart Disease
Pulmonary Circulation
Atrial Pressure
Intratracheal Intubation
Adult Respiratory Distress Syndrome
Cardiac Catheterization
Naloxone
Embolism
Hypotension
Infarction
Opioid Analgesics
Lung Diseases
Coronary Artery Disease
Heart Diseases
Sepsis
Norepinephrine

Keywords

  • respiratory failure
  • right ventricle dysfunction
  • shock

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

A novel case of transient right ventricular failure in a patient with respiratory distress. / Liu, Stanley S.; Kovell, Lara C.; Horne, Aaron; Chang, David; Petronis, John D.; Zakaria, Sammy.

In: Journal of Intensive Care Medicine, Vol. 28, No. 3, 05.2013, p. 185-188.

Research output: Contribution to journalArticle

Liu, Stanley S. ; Kovell, Lara C. ; Horne, Aaron ; Chang, David ; Petronis, John D. ; Zakaria, Sammy. / A novel case of transient right ventricular failure in a patient with respiratory distress. In: Journal of Intensive Care Medicine. 2013 ; Vol. 28, No. 3. pp. 185-188.
@article{3e0c6e7e7d484cd8af66358b882c845e,
title = "A novel case of transient right ventricular failure in a patient with respiratory distress",
abstract = "Right ventricular (RV) failure is characterized by an inability to pump blood into the pulmonary circulation and can often lead to hemodynamic instability. Common causes of RV failure include left ventricular (LV) failure, RV infarction, sepsis, cor pulmonale due to acute respiratory distress syndrome, pulmonary emboli, or pulmonary hypertension. We report the case of a 61-year-old woman with no significant pulmonary or cardiac disease who presented with hypoxic respiratory failure in the setting of opioid overdose. She remained obtunded despite naloxone treatment and required endotracheal intubation as well as norepinephrine therapy for persistent hypotension. A transthoracic echocardiogram demonstrated isolated severe RV dysfunction without any LV abnormalities. Cardiac catheterization showed no obstructive coronary artery disease, pulmonary hypertension, or elevated left atrial pressures, and chest imaging only revealed signs of aspiration. Over the next 6 days, the patient's cardiac and respiratory function improved, and a repeat echocardiogram demonstrated complete normalization of RV function. This case demonstrates a novel finding that marked, but transient, RV dysfunction can occur in the setting of acute respiratory failure.",
keywords = "respiratory failure, right ventricle dysfunction, shock",
author = "Liu, {Stanley S.} and Kovell, {Lara C.} and Aaron Horne and David Chang and Petronis, {John D.} and Sammy Zakaria",
year = "2013",
month = "5",
doi = "10.1177/0885066612443121",
language = "English (US)",
volume = "28",
pages = "185--188",
journal = "Journal of Intensive Care Medicine",
issn = "0885-0666",
publisher = "SAGE Publications Inc.",
number = "3",

}

TY - JOUR

T1 - A novel case of transient right ventricular failure in a patient with respiratory distress

AU - Liu, Stanley S.

AU - Kovell, Lara C.

AU - Horne, Aaron

AU - Chang, David

AU - Petronis, John D.

AU - Zakaria, Sammy

PY - 2013/5

Y1 - 2013/5

N2 - Right ventricular (RV) failure is characterized by an inability to pump blood into the pulmonary circulation and can often lead to hemodynamic instability. Common causes of RV failure include left ventricular (LV) failure, RV infarction, sepsis, cor pulmonale due to acute respiratory distress syndrome, pulmonary emboli, or pulmonary hypertension. We report the case of a 61-year-old woman with no significant pulmonary or cardiac disease who presented with hypoxic respiratory failure in the setting of opioid overdose. She remained obtunded despite naloxone treatment and required endotracheal intubation as well as norepinephrine therapy for persistent hypotension. A transthoracic echocardiogram demonstrated isolated severe RV dysfunction without any LV abnormalities. Cardiac catheterization showed no obstructive coronary artery disease, pulmonary hypertension, or elevated left atrial pressures, and chest imaging only revealed signs of aspiration. Over the next 6 days, the patient's cardiac and respiratory function improved, and a repeat echocardiogram demonstrated complete normalization of RV function. This case demonstrates a novel finding that marked, but transient, RV dysfunction can occur in the setting of acute respiratory failure.

AB - Right ventricular (RV) failure is characterized by an inability to pump blood into the pulmonary circulation and can often lead to hemodynamic instability. Common causes of RV failure include left ventricular (LV) failure, RV infarction, sepsis, cor pulmonale due to acute respiratory distress syndrome, pulmonary emboli, or pulmonary hypertension. We report the case of a 61-year-old woman with no significant pulmonary or cardiac disease who presented with hypoxic respiratory failure in the setting of opioid overdose. She remained obtunded despite naloxone treatment and required endotracheal intubation as well as norepinephrine therapy for persistent hypotension. A transthoracic echocardiogram demonstrated isolated severe RV dysfunction without any LV abnormalities. Cardiac catheterization showed no obstructive coronary artery disease, pulmonary hypertension, or elevated left atrial pressures, and chest imaging only revealed signs of aspiration. Over the next 6 days, the patient's cardiac and respiratory function improved, and a repeat echocardiogram demonstrated complete normalization of RV function. This case demonstrates a novel finding that marked, but transient, RV dysfunction can occur in the setting of acute respiratory failure.

KW - respiratory failure

KW - right ventricle dysfunction

KW - shock

UR - http://www.scopus.com/inward/record.url?scp=84877939672&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877939672&partnerID=8YFLogxK

U2 - 10.1177/0885066612443121

DO - 10.1177/0885066612443121

M3 - Article

VL - 28

SP - 185

EP - 188

JO - Journal of Intensive Care Medicine

JF - Journal of Intensive Care Medicine

SN - 0885-0666

IS - 3

ER -