Increased RV afterload, RV hypertrophy and eventual dilatation
Increased wall stress and O2 consumption, reduced coronary perfusion (more dependent on diastolic filling, as in LV)
RV-PA uncoupling (RV contractility cannot match afterload) results in RV dysfunction and right heart failure
Worsening TR also contributes to reduced output
“Backward failure”: Venous congestion – liver, renal, GI (translocation) etc.
“Forward failure”: Ventricular interdependence, impaired LV filling, reduced cardiac output
