Right Ventricular Assessment

The right ventricle sometimes has been called the forgotten ventricle. In the intensive care setting, however, this should really never be the case. The right ventricle is not adapted to high afterload and right ventricular dysfunction is commonly seen in acute disease, and especially acute lung disease. This has specific management implications and prognostic significance. Adding to the general difficulty of right ventricular assessment is the complex geometry of the right ventricle, the sensitivity of the right ventricle to both preload and afterload, and confounding factors such as limited views, presence of atrial fibrillation, concomitant tricuspid regurgitation and/or right ventricular pacing. In this chapter, we will focus on assessment of right ventricular size and function in a practical manner with relevant case scenarios of typical patients admitted to the medical intensive care unit.