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THE RIGHT CARDIAC INSUFFICIENCY

- Definition
- A few explanations
- The Symptoms
- How to make the diagnosis?
- The Causes
- Evolution and Prognosis
- Treatment

TREATMENT

1 - Goal

The treatment of the right cardiac insufficiency has a double objective: a symptomatic objective, by fighting against the retention of water and salt by the organism and by improving the function of contraction of the heart muscle, and the treatment of the cause.

2 - Treating the cause

The treatment of the chronic pulmonary heart associates therapeutic measures and dietary- hygienic measures common to the chronic respiratory insufficiencies. Let us note that the administration of oxygen is the best treatment of the pulmonary arterial hypertension.

The treatment in case of an acute pulmonary heart due to a pulmonary embolism rests on the prescription of an anticoagulant treatment.

The surgical treatment of an illness of a heart valve in semi-emergency, or of a congenital illness of the heart permits preventing the installation of a definitive pulmonary arterial hypertension.

3 - Means of the symptomatic treatment

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They are superimposable to those used in the left ventricular insufficiency. The use of the anticoagulants is more frequent because of the strong risk of occurrence of a clot, then responsible for the occurrence of a pulmonary embolism considerably aggravating the prognosis.

4 - Indications

They differ depending on whether the cardiac insufficiency is global or pure, right and ventricular.

Dietary-hygienic rules and diuretics are prescribed extensively. Dietary-hygienic rules consist in reducing the contribution in salt and in water. Effusions are to be evacuated. The regression of the symptoms must make way for a keeping up treatment that will be increased in case of a new outbreak.

The occurrence of a renal insufficiency obliges to reduce the diuretic medicines posologies.

Cardiotonic drugs are less efficient on the right ventricular deficiency than in the left ventricular insufficiency. Nevertheless, they must be prescribed in case of an atrial fibrillation.

It is the same with the venous and mixed vasodilators, but the global cardiac insufficiency is one of their privileged indications.

Of course, the research of an activating cause is essential.

5 - Monitoring

The surveillance of the oedemas regression and of the size of the liver is made by simple clinical measures: measure of the weight, measure of the quantity of urine on 24 hours, daily clinical exams.

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File last reviewed on dec 18, 2011