Right heart failure

The right heart is distinct from the left heart in multiple ways, starting with its embryological origin to its vascular supply, molecular regulation, innervation, architectural structure, and function. It also differs from the left heart in its response to stress, injury, and disease. This chapter details the unique nature of the right heart including its adaptations when responding to normal and pathological states-with the ability to adapt to differential loads, structural changes, injury, and disease. Included are descriptions on how specific diseases affect the right heart. Pulmonary hypertension, for example, is the most common cause of right ventricular failure. Myocardial infarction, genetic disease, and carcinoid can also promote right heart failure. Developing patient registries and using imaging technologies and molecular analyses will provide a deeper understanding of disease mechanisms and, ultimately, help guide new therapies to address right heart failure. These therapies are an area of intense interest.