Key Points
- To investigate whether acute massive pulmonary embolism can precipitate isolated right ventricular infarction in patients without pre-existing right ventricular hypertrophy.
- Retrospectively analyzed post-mortem records to identify 6 cases of massive pulmonary embolism presenting with pure right ventricular infarction from a total series of 216 autopsies.
- Evaluated clinical, electrocardiographic, and hemodynamic parameters alongside pathological assessments of right ventricular myocardial thickness, necrosis distribution, and coronary artery lesions.
- All 6 cases exhibited normal right ventricular wall thickness without left ventricular involvement or mural thrombi; necrosis was transmural in 4 cases and subendocardial in 2 cases across the anterolateral and posterior walls.
- Significant lesions in coronary arteries occurred in 5 patients, while 1 patient exhibited completely normal coronary arteries.
Structured PICO
PPopulation6 autopsied patients with massive pulmonary embolism and pure right ventricular infarction, selected from a population of 216 autopsies.
OOutcomePathological characteristics of right ventricular infarction (transmural vs subendocardial, coronary artery involvement)
Right ventricular infarction can occur secondary to massive pulmonary embolism even without right ventricular hypertrophy, potentially exacerbated by underlying coronary lesions.