# Longembolie met rechterventrikel-falen: pathofysiologie en acute behandelstrategieën

*geplaatst 2026-11-11 · Hartfalen · Clinics in chest medicine · doi 10.1016/j.ccm.2026.07.001 · https://hartvaat.nl/2026/12/01/longembolie-met-rechterventrikel-falen-pathofysiologie-en-acute-behandelstrategi/*

Deze narratieve review beschrijft de pathofysiologie, diagnostiek en acute behandeling van rechterventrikel-falen bij longembolie in de spoedeisende hulp en intensive care. De auteurs benadrukken de centrale rol van obstructieve shock, de waarde van snelle risicostratificatie en beeldvorming, en evalueren de effectiviteit van trombolysen, kathetergerichte interventies en chirurgische embolectomie. Het overzicht helpt clinici om hemodynamische instabiliteit vroegtijdig te herkennen en gepaste reperfusionstherapieën tijdig in te zetten.

## English: Pathophysiology of Right Ventricular Failure in Pulmonary Embolism.

This narrative review examines the pathophysiology, diagnostic workup, and acute management of right ventricular failure following pulmonary embolism in hemodynamically unstable patients. It highlights the critical link between mechanical obstruction and obstructive shock, detailing risk stratification strategies, emerging biomarkers, and the comparative roles of systemic thrombolysis, catheter-directed therapies, and surgical embolectomy. Provides emergency and critical care clinicians with a structured framework to accelerate recognition and tailor reperfusion interventions to improve hemodynamic stability and outcomes.

## Abstract (original, from the publication)

Acute pulmonary embolism (PE) is a potentially life-threatening condition that can precipitate obstructive shock, a form of circulatory failure caused by the mechanical obstruction of blood flow through the pulmonary circulation. This article explores the pathophysiological mechanisms linking massive PE to obstructive shock, highlighting key diagnostic challenges, and the importance of rapid recognition in the emergency setting. We examine current strategies for risk stratification, imaging, and laboratory testing, as well as emerging biomarkers that may aid in early identification. The article also evaluates the efficacy and limitations of therapeutic interventions, including systemic thrombolysis, catheter-directed therapies, and surgical embolectomy, in the context of hemodynamic instability. Understanding the complex interplay between PE and obstructive shock is essential for optimizing outcomes in critically ill patients.

Auteurs: Neel V Gadhoke, Isabella Tous, Renuka Reddy, Steven Pugliese, Sanjum Sethi, Amir Darki

---
Bron: Clinics in chest medicine, https://doi.org/10.1016/j.ccm.2026.07.001. Bijgewerkt 2026-11-05T01:54:11Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.