🫁 Right Ventricular Strain and Hemodynamic Collapse Simulator

Normal RV Function and Pulmonary Circulation

Healthy RV pumps low-pressure, low-resistance flow to the lungs.

• 1x: Normal PVR (baseline reference)
• ~3-5mm: RV wall thickness (thin, compliant)
• 100%: Normal CO (resting baseline)
• ~90-118: Mean systemic BP (mmHg, stable)

RV as a low-pressure pump

Thin-walled RV suited to a low-resistance pulmonary circuit.

Septal geometry at rest

Septum curves toward RV; LV filling is unimpeded.

Acute Pulmonary Arterial Obstruction

A large embolus lodges, blocking a major share of pulmonary flow.

• >50%: Clot burden (flow blocked, massive PE)
• Sudden: Onset (minutes)
• DVT: Source (proximal leg veins, typical)
• Large: Territory affected (main/lobar arteries)

Where clots lodge

Large emboli wedge at main or lobar pulmonary artery bifurcations.

Immediate mechanical effect

Flow is diverted, cross-sectional area for perfusion drops sharply.

Pulmonary Vascular Resistance and Acute RV Afterload

Obstruction plus reflex vasoconstriction sharply raises PVR.

• Up to 5x: PVR rise (relative to baseline)
• Acute ↑: RV afterload (sudden pressure load)
• Hypoxia, serotonin: Mediators (vasoconstrictors released)
• Minutes: Time course (rapid onset)

Mechanical + humoral resistance rise

Physical obstruction compounds with vasoactive mediator release.

RV pressure-work spikes

Unprepared thin RV faces a sudden, steep pressure load.

RV Dilation, Wall Tension, and Septal Bowing

The RV dilates, wall tension rises, septum bows into the LV.

• Marked: RV size increase (acute dilation)
• Leftward: Septal shift (bows into LV cavity)
• Reduced: LV filling (via septal compression)
• High: Wall tension (Laplace relationship)

Dilation and wall stress

Rising volume and pressure raise RV wall tension acutely.

Ventricular interdependence

Bowing septum crowds LV, limiting its diastolic filling.

Falling Output and Obstructive Shock

Cardiac output and BP fall; shock develops without urgent care.

• ↓↓: Cardiac output (markedly reduced)
• <90 mmHg: Systemic BP (hypotension threshold)
• Obstructive: Shock type (mechanical outflow block)
• Immediate: Urgency (thrombolysis/embolectomy)

Output collapse mechanism

Reduced LV preload plus failing RV output drop systemic flow.

Urgent reperfusion therapy

Thrombolysis, embolectomy, or anticoagulation reverse the cascade.

Rapid reperfusion can reverse RV strain before arrest.