Right Heart Failure from Pulmonary Embolism

Acute right heart failure (RHF) is an important presentation of acute pulmonary artery thromboembolism (PE). The hemodynamic nature of acute right ventricular failure is fundamentally different from that of chronic right ventricular failure. Recognizing important clinical signs, along with imaging modalities such as Transthoracic echocardiogram, lung ventilation/perfusion scintigraphy scan and computed tomographic pulmonary angiography (CTPA), can help to make an early diagnosis. Early treatment with anticoagulants and/or thrombolysis, helps to improve in-hospital survival and reduce long-term pulmonary arterial hypertension. Systemic or catheter directed thrombolysis plays a vital role in patients with hemodynamic instability. The role of advanced hemodynamic support devices as an adjuvant therapy is limited to only specialized centers with experienced operators.