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Right Ventricular Failure: Understanding Edema, Breathing Difficulties, and Effective Treatment

Right ventricular failure can lead to a variety of symptoms that significantly impact a patient's quality of life. One such case involved a 67-year-old woman who began experiencing unexplained swelling and reduced urine output approximately one month prior to her hospital visit. Over time, the swelling worsened, and about ten days before admission, she developed intermittent chest tightness and shortness of breath. After a comprehensive evaluation including abnormal ECG findings, physical examination, and immunoserological tests, she was diagnosed with right ventricular failure. With timely medical intervention, her condition stabilized, and symptoms such as edema and dyspnea subsided.

Key Patient Information

  • Age & Gender: 67-year-old female
  • Diagnosis: Right ventricular failure
  • Hospital: First Affiliated Hospital of Xi'an Jiaotong University
  • Admission Date: February 2021
  • Treatment Plan: Oral diuretics (furosemide and spironolactone) + intravenous administration of deslanoside injection
  • Treatment Duration: 7-day hospitalization with a follow-up appointment scheduled one month later
  • Outcome: Significant symptom relief with stable clinical condition

Initial Presentation and Diagnosis

The patient reported the gradual onset of leg swelling and decreased urine output without any apparent trigger. About ten days prior to admission, she began experiencing intermittent chest discomfort, especially during physical exertion, along with nighttime dyspnea and orthopnea. Upon physical examination, her heart rate was 105 beats per minute with a regular rhythm and no murmurs or pericardial friction rub. Abdominal percussion revealed tympany, and she exhibited pitting edema in both lower extremities. An ECG showed sinus rhythm with ST-T wave abnormalities, suggesting myocardial ischemia. Laboratory testing revealed elevated levels of pro-B-type natriuretic peptide at 470.2 pg/mL. Based on these findings and her clinical presentation, right ventricular failure was diagnosed, and hospitalization was initiated for treatment.

Therapeutic Approach and Progress

After discussing the condition and treatment options with the patient, a conservative management plan was chosen. She was prescribed oral diuretics—furosemide and spironolactone—to reduce fluid retention and alleviate symptoms such as swelling and breathlessness. Additionally, she received intravenous deslanoside to enhance myocardial contractility, addressing the weakened heart function associated with right ventricular failure. Within seven days of hospitalization, her condition improved significantly, allowing for discharge with instructions for a follow-up visit one month later.

Clinical Response and Recovery

Following the prescribed treatment and supportive care, the patient experienced complete resolution of chest discomfort and lower limb edema. Her blood pressure returned to normal, and no other abnormalities were detected upon physical examination. She was discharged with a favorable prognosis. At her one-month follow-up, she was in good general health, with normal urinary and bowel function, and no recurrence of symptoms. She was advised to continue her medication regimen and monitor her condition closely, seeking medical attention if any new symptoms arose.

Post-Treatment Care Recommendations

While the patient's recovery was promising, ongoing care is essential in managing right ventricular failure. Here are key recommendations for long-term health:

  • Medication Adherence: Continue prescribed medications as directed and avoid self-modifying dosages or discontinuing treatment without medical guidance.
  • Lifestyle Adjustments: Ensure adequate rest and gradually reintroduce low-impact physical activities such as walking or tai chi once heart function improves.
  • Skin and Mobility Care: For patients requiring prolonged bed rest, regular skin care and repositioning are crucial to prevent pressure ulcers.

Clinical Insights and Patient Advocacy

Right ventricular failure, a subset of heart failure, can lead to severe complications if not addressed promptly. In this case, early diagnosis and appropriate treatment led to a favorable outcome, with the patient regaining her health and resuming daily activities. It is essential to raise awareness about the signs of heart failure and encourage timely medical evaluation. Delaying care can lead to worsening symptoms and potentially life-threatening conditions. If you or a loved one experiences unexplained swelling, fatigue, or difficulty breathing, seek professional medical advice without delay.

AutumnWhispe2025-08-03 11:06:46
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