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The Lab

Disease states

Acute Pulmonary Embolism · Severe Right Ventricular Failure

Acute pulmonary arterial obstruction with severe RV failure, reduced LV filling and low forward perfusion. This is a high-risk PE phenotype; a saddle embolus alone does not establish hemodynamic severity.

Overview

Select Acute Pulmonary Embolism · Severe Right Ventricular Failure under Clinical controls → Hemodynamic state. The bold italic live label confirms the active selection. These are the preset’s teaching features; combined disease, rate and interventions can change the resulting numbers.

Acute pulmonary arterial obstruction with severe RV failure, reduced LV filling and low forward perfusion. This is a high-risk PE phenotype; a saddle embolus alone does not establish hemodynamic severity.

High RAP/RVEDP with low-normal wedge and LVEDP localizes the dominant problem to RV afterload and forward flow.

PA pressure is moderately elevated despite high PVR; an acutely failing RV need not generate the very high pressures of chronic PH.

Tachycardia, AF or flutter are selectable presentations. Bradycardia, slow AF and junctional escape illustrate advanced peri-arrest deterioration, not routine PE.

Acute RV strain may cause RBBB, incomplete RBBB, S1Q3T3, S1S2S3 and anterior/inferior T inversion. None is diagnostic; an RVH pattern implies prior pressure loading.

Fibrinolysis demonstrates partial relief of pulmonary obstruction; coronary angioplasty does not treat PE.

Step by step

  1. Reset interventions if you want the untreated example.
  2. Select the condition and inspect the pressure summary and relevant waveforms.
  3. Pause for annotations; add one intervention or loading change to compare the response.

References & further reading

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