What changes are associated with right ventricular dysfunction/failure?

Right ventricular dysfunction or failure leads to a series of significant hemodynamic changes primarily affecting the right side of the heart and subsequently impacting systemic circulation and venous return. In such cases, one hallmark observation is an increase in central venous pressure (CVP). This occurs because the right ventricle's inability to pump effectively causes a backlog of blood in the venous system, leading to elevated CVP measurements.

Moreover, right ventricular failure often results in a decrease in cardiac output (CO) because the right ventricle cannot adequately deliver blood to the lungs for oxygenation. A decreased cardiac output can significantly affect overall systemic blood pressure, leading to lower systemic blood pressures, though this is not always a direct relationship depending on other compensatory mechanisms in the body.

In the context of pulmonary artery wedge pressure (PAWP), when right ventricular dysfunction occurs, it is primarily the left side's pressures that are indirectly affected due to the overall decrease in output and increased pressure on the right. Therefore, we typically do not see decreases in PAWP in cases of right ventricular dysfunction; rather, it may remain normal or even increase as the left heart compensates.

The correct choice encompasses these physiological changes, accurately reflecting that right ventricular dysfunction results in decreased cardiac