Medical Management and Mechanical Circulatory Support Escalation in Right Ventricular Failure.

Right ventricular (RV) failure is a clinically distinct entity with significant prognostic implications across multiple cardiovascular conditions. Its diagnosis is challenging due to overlapping features with left ventricular failure, often leading to delayed recognition. This article reviews the unique pathophysiology, clinical presentation, and diagnostic strategies for RV failure, emphasizing hemodynamic assessment. A structured approach to medical management is presented, focusing on optimization of preload, afterload, contractility, and rhythm control. Disease-specific considerations and timely escalation to mechanical circulatory support are discussed to improve outcomes in patients with RV-related cardiogenic shock.