Abstract
Acute circulatory failure that complicates massive pulmonary embolism (MPE) is the major form of acute cor pulmonale (ACP). This kind of right ventricular dysfunction results from the inability of the right ventricle to handle an acute excess of pressure, and is directly related to the degree of pulmonary vascular obstruction. Echocardiography is the best and more accurate means of detecting ACP. Even if finding ACP on the echocardiographic study indicates the presence of a large obstruction, it does not necessarily imply a negative prognosis and does not require thrombolytic therapy. Only associated metabolic acidosis indicates a high risk of death from refractory circulatory failure.
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