Fig. 1

Pathophysiology of pulmonary embolism. Due to obstruction of the pulmonary vascular bed, increased vascular resistance, and increased RV afterload, PE can lead to RVD. RVD can have several consequences. First, it can decrease RV output. Second, RVD may result in a decrease of LV preload and output, caused by an increased RV volume and dilatation, eventually leading to decreased cardiac output. Finally, RVD can cause decreased coronary perfusion, leading to ischemia, which in turn results in a further increase of RVD. RV = right ventricle, PE = pulmonary embolism, RVD = right ventricular dysfunction, LV = left ventricle, PA = pulmonary artery