Managing Decompensated RV Failure in PAH: Key Strategies

In this in-depth episode, the CardioNerds team welcomes Dr. Mardi Gomberg‑Maitland (GW Pulmonary Hypertension Program) and Dr. Rachel Damico (Johns Hopkins) to explore the challenging management of decompensated right ventricular (RV) failure in pulmonary arterial hypertension (PAH). Using a compelling case of a 21-year-old woman with congenital heart disease and severe PAH receiving triple therapy who presents in cardiogenic shock, the discussion unpacks the clinical spectrum of RV failure—from subtle volume overload to overt shock—emphasizing early hypoxemia as a sentinel sign. The CardioNerds team and Drs. Gomberg Maitland and Damico review diagnostic approaches, urgent management strategies in the ICU and on the wards, prognostic considerations, and the critical importance of early goals-of-care discussions alongside involvement of pulmonary hypertension (PH) specialists for advanced interventions.

This podcast originally appeared on The CardioNerds.