Clinical Scorecard: Uncoupling of Right Ventricular and Pulmonary Arterial Function with Venous Overload in Normotensive Shock Due to Pulmonary Embolism
At a Glance
Category
Detail
Condition
Acute Pulmonary Embolism
Key Mechanisms
Right ventricular dysfunction and pulmonary arterial coupling
Target Population
Patients with normotensive shock due to pulmonary embolism
Care Setting
Emergency and critical care settings
Key Highlights
Qualitative RV hypokinesis predicts 30-day mortality in normotensive PE patients.
TAPSE/PASP ratio is preferred for assessing RV function and predicting mortality.
VExUS captures hemodynamic alterations and correlates with PE severity.
Guideline-Based Recommendations
Diagnosis
Use TAPSE/PASP and VExUS for assessing RV function in acute PE.
Management
Consider hemodynamic-driven stratification for reperfusion therapies.
Monitoring & Follow-up
Monitor TAPSE/PASP and VExUS scores to evaluate RV-PA coupling.
Risks
Inadequate TRV signal limits the assessment of RV function.
Patient & Prescribing Data
Patients with acute pulmonary embolism presenting with normotensive shock.
Mechanical thrombectomy may lead to significant cardiac index improvement in patients with low TAPSE/PASP.
Clinical Best Practices
Incorporate quantitative metrics for RV function assessment.
Utilize VExUS for evaluating venous overload and cardiac function.
by José Carlos Gasca-Aldama, Karen Harumi López-Rodríguez, Mario Arturo Carrasco-Flores, Juan Ángel Morales-Ferrer, Osvaldo Alexis Marché-Fernández, Marcos Vidals-Sánchez, José Ernesto Juárez-León, Mónica Libertad Moya-Alfaro, Eduardo Alberto González-Escudero
