ACUTE PULMONARY HYPERTENSION
The right ventricle is under acute stress in pulmonary hypertension because it must pump against markedly increased pulmonary vascular resistance.
Four simultaneous goals of Treatment:
1. Raise systemic BP → protect RV coronary perfusion
2. Strengthen RV → improve forward flow
3. Lower PVR → make it easier for RV to eject
4. Optimize preload → neither empty nor overloaded RV
Severe hypotension + RV failure → Norepinephrine/vasopressin ± inotrope
Severe PVR → iNO/inhaled prostacyclin
Refractory shock → VA-ECMO + definitive treatment of the cause
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2August 16, 2026 4.2K 7
