Right-sided congestive heart failure can be precipitated by which of the following?

Right-sided congestive heart failure can be precipitated by which of the following?

• A. Left-sided CHF
• B. Pulmonary embolism
• C. Chronic obstructive pulmonary disease
• D. Severe asthma

Answer: (D)

Right-sided heart failure happens when the right ventricle can’t push blood through the lungs against the pulmonary vascular resistance. A key way this resistance rises is pulmonary hypertension. Severe asthma can contribute to this by causing significant hypoxemia during attacks, which triggers hypoxic vasoconstriction in the small pulmonary arteries. Recurrent or severe hypoxemic episodes can lead to remodeling and higher pulmonary pressures, so the right ventricle has to work harder, eventually hypertrophying and possibly failing. In this way, severe asthma can precipitate right-sided CHF through the development of pulmonary hypertension driven by chronic or severe hypoxemia.

Right-sided heart failure happens when the right ventricle can’t push blood through the lungs against the pulmonary vascular resistance. A key way this resistance rises is pulmonary hypertension. Severe asthma can contribute to this by causing significant hypoxemia during attacks, which triggers hypoxic vasoconstriction in the small pulmonary arteries. Recurrent or severe hypoxemic episodes can lead to remodeling and higher pulmonary pressures, so the right ventricle has to work harder, eventually hypertrophying and possibly failing. In this way, severe asthma can precipitate right-sided CHF through the development of pulmonary hypertension driven by chronic or severe hypoxemia.