Right ventricular dysfunction – the difficulties of differential diagnostics

Grytė Ramantauskaitė1, Kamilė Gerulytė1, Jolanta Elena Marcinkevičienė2

1Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

2Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania


Right ventricular failure is a common clinical syndrome, which causes a lot of diagnostic issues. To prevent damages to the heart, it is very important to identify the causes as soon as possible and prescribe adequate treatment. Patients with right ventricular dysfunction usually complain about shortness of breath during exercise and rest, also common symptoms are peripheral edema, chest pain, and fatigue during severe intensity exercises. Those symptoms are common to many different diseases, that is why comprehensive differential diagnostics are required to determine the cause of the complaints. It is very important to remember, that right ventricular failure is a complication of the primary disease. The main causes are ischemia, heart muscle diseases (myocarditis, cardiomyopathy), valvular diseases (tricuspid valvular regurgitation and stenosis, pulmonary valve regurgitation and stenosis), pulmonary hypertension, pulmonary embolism, congestive heart failure with the progression of left ventricular dysfunction. It is important to diagnose right ventricular failure and to evaluate all possible causes to find out the real cause of the disease. Symptoms mentioned before usually are caused by more than one disease, and could be predisposed by many reasons. In this article, we presented a case of 71 years old patient, with an unknown origin of the right ventricular dysfunction. The purpose of this case is to revealed differential diagnostics possibilities and difficulties and to identify the possible causes of right ventricular failure.

Keywords: right ventricular failure, pulmonary embolism, valvular disease, heart failure.