Pathophysiology in Pulmonary Embolism

Abstract

There has been a widespread and detailed work about pulmonary embolism. It seems well accepted that in cardiopulmonary healthy persons hemodynamic changes are due to the degree of obstruction of the pulmonary vascular bed (1, 5, 6). Our so far available investigation in patients with angiographically proven massive pulmonary embolism confirmed the findings of Mclntyre and Sasahara (5, 6) and of Miller and Sutton (7). Since the earliest time we have investigated our patients has been at least one and a half hours after the clinical event of pulmonary embolism, we believe, that these patients are already a selection of those who primarily survived. Data on the immediate response to massive pulmonary embolism in man are therefore not available. The central problem appears to be the ability of the right ventricle to compensate for a sudden increase in pulmonary vascular resistance. Therefore it seemed most interesting to us to get some information about the development of right ventricular force in the first essential seconds and minutes. Thus we evaluated the first reaction post embolization in dogs.