Diagnosis and treatment of right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale): a clinical consensus statement of the Association for Acute CardioVascular Care of the European Society of Cardiology

ESC ACVC · 2023 · Switzerland

Source and licence

Authors
Mattia Arrigo, Susanna Price, Veli-Pekka Harjola et al.
Title
Diagnosis and treatment of right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale): a clinical consensus statement of the Association for Acute CardioVascular Care of the European Society of Cardiology
Journal
European Heart Journal. Acute Cardiovascular Care, 2023
Licence
CC BY 4.0
Changes
Verbatim excerpts; formatting adapted

Full text retrieved 2026-10-27 from Europe PMC · PMC10927027

Licence statement of the original publication

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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Recommendations

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Abstract

Acute right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale) is a life-threatening condition that may arise in different clinical settings. Patients at risk of developing or with manifest acute cor pulmonale usually present with an acute pulmonary disease (e.g. pulmonary embolism, pneumonia, and acute respiratory distress syndrome) and are managed initially in emergency departments and later in intensive care units. According to the clinical setting, other specialties are involved (cardiology, pneumology, internal medicine). As such, coordinated delivery of care is particularly challenging but, as shown during the COVID-19 pandemic, has a major impact on prognosis. A common framework for the management of acute cor pulmonale with inclusion of the perspectives of all involved disciplines is urgently needed.

Contents of the original publication

The section headings of the original.

  • Purpose and aim
  • Methods
  • Clinical vignette
  • Anatomical and physiological particularities of the right ventricle
  • Pathophysiology of acute right ventricular failure
  • Diagnosis of acute cor pulmonale
  • Clinical diagnosis
  • Biochemistry/biomarkers
  • Imaging
  • Haemodynamic monitoring in acute cor pulmonale
  • Oxygen and ventilatory support in acute cor pulmonale
  • Ventilation in specific scenarios
  • Medical treatment of acute cor pulmonale
  • Volume optimization
  • Vasopressor and inotrope treatment
  • Specific treatments for the underlying cause of acutely increased right ventricular afterload
  • Mechanical circulatory support for acute right ventricular failure
  • Conclusion

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