Chronic Right Heart Failure Expanding Prevalence and Challenges in Outpatient Management

Failure of the right side of the heart is caused by dysfunction of the right side of the heart resulting in suboptimal stroke volume to supply the pulmonary circulation. Therapeutic developments mean that patients with acute failure of the right side of the heart survive to hospital discharge and live with chronic failure of the right side of the heart. Management of chronic failure of the right side of the heart aims to reduce afterload, optimize preload, and support contractility, with the best evidence available in vascular targeted therapy for pulmonary arterial hypertension. However, the management of chronic failure of the right side of the heart relies on adapting therapies for left ventricular heart failure to the right. The authors review management of failure of the right side of the heart in the ambulatory setting and its challenges.