[Acute infarct of the right ventricle secondary to a massive pulmonary thromboembolism]

The hemodynamic and cardiovascular responses to a massive pulmonary embolism are: severe pulmonary hypertension, right ventricular failure and cardiogenic shock. The irreversible state of the latest condition and mortality could be due to a secondary right ventricle myocardial infarction, an entity which was first described in 1949. We report a necropsy case with massive pulmonary embolism and as a relevant finding a recent right ventricular myocardial infarction without significant obstructive coronary lesions. The relevance of right ventricle myocardial infarction as a major risk factor for mortality, its clinical and hemodynamic profile as well as the ischemic phenomena, are analyzed. It is emphasized also the importance of an early lysis of thrombus to rescue myocardium and to preserve right ventricle viability. This could be the first case reported in Mexico, in which the relationship between massive pulmonary embolism and right ventricle myocardial infarction is demonstrated as a determinant factor for mortality.