{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T22:11:37Z","timestamp":1774044697609,"version":"3.50.1"},"reference-count":63,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Federico II University of Naples, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The right heart\u2013pulmonary circulation unit (RH-PCU) constitutes an integrated anatomo-functional system characterized by high-volume blood flow, low intravascular pressure, and minimal pulmonary vascular resistance. The RH-PCU dysfunction is a challenge for clinicians, as it can result from numerous pathological conditions, each with different clinical presentations. The pathophysiological changes underlying the hemodynamic alterations in the pressure and volume affecting the right ventricle can lead the patient to present with the primary symptom: dyspnea. We review the clinical presentation, the laboratory test, and the role of multimodality imaging in the evaluation of the disfunction of the RHPCU, including echocardiography, stress echocardiography, computed tomography, magnetic resonance imaging, nuclear imaging, and invasive pressure measurement through catheterization. We therefore aimed to describe the various diagnostic options available to clinicians, evaluating their effectiveness and limitations of use.<\/jats:p>","DOI":"10.3390\/life15081194","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T07:57:24Z","timestamp":1753689444000},"page":"1194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Right Heart Evaluation: A Tough Challenge for Clinicians"],"prefix":"10.3390","volume":"15","author":[{"given":"Martina","family":"Pucci","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca Maria","family":"Capece","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariateresa","family":"Pontoriero","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Paoletta","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Iacono","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"La Rocca","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95122 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Luise","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1161\/CIRCULATIONAHA.107.653584","article-title":"Right ventricular function in cardiovascular disease, part II: Pathophysiology, clinical importance, and management of right ventricular failure","volume":"117","author":"Haddad","year":"2008","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1111\/echo.13594","article-title":"Imaging the right heart pulmonary circulation unit: Insights from advanced ultrasound techniques","volume":"34","author":"Ferrara","year":"2017","journal-title":"Echocardiography"},{"key":"ref_3","first-page":"315","article-title":"Lung ultrasound in the critically ill","volume":"20","author":"Lichtenstein","year":"2014","journal-title":"Ann. 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