Pathophysiology: Acute Pulmonary Embolism with Normotensive Shock

This presentation was developed for NRSG 435/535 Pathophysiology as part of the “Pathophysiology in the Headlines” assignment. Using a published case of acute pulmonary embolism with normotensive shock, the presentation examines the pathophysiologic progression from pulmonary vascular obstruction to increased right ventricular afterload, impaired left ventricular filling, reduced cardiac output, systemic hypoperfusion, obstructive shock, and cardiac arrest. The discussion integrates current peer-reviewed evidence to explain the patient’s clinical findings, compensatory responses, and subsequent decompensation. References: Bukhari, S. M. A., Hunter, J. G., Bera, K., Tippareddy, C., Johnson, C. R., Ravi, S., Chakraborti, S., Gilkeson, R. C., & Gupta, A. (2025). Clinical and imaging aspects of pulmonary embolism: A primer for radiologists. Clinical Imaging, 117, 110328. https://doi.org/10.1016/j.clinimag.2024.11... Henkin, S., Ujueta, F., Sato, A., & Piazza, G. (2024). Acute pulmonary embolism: Evidence, innovation, and horizons. Current Cardiology Reports, 26, 1249–1264. https://doi.org/10.1007/s11886-024-02128-0 Rouleau, S. G., Anderson, D., Chou, L.-C. P., Evans, S. A., & Liu, G. Y. (2026). Management of presumed pulmonary embolism with normotensive shock. Case Reports in Critical Care, 2026, Article 4107549. https://doi.org/10.1155/crcc/4107549 Valencia Uribe, J., Attia, M., Perez Tagle Tejeda, A., Seifert, K., Valentin, R. G., & Mayer, D. (2026). Reviving the standstill heart: Multimodal management of refractory cardiac arrest due to massive pulmonary embolism. Case Reports in Critical Care, 2026, Article 6192253. https://doi.org/10.1155/crcc/6192253 Zuin, M., Henkin, S., Harder, E. M., & Piazza, G. (2024). Optimal hemodynamic parameters for risk stratification in acute pulmonary embolism patients. Journal of Thrombosis and Thrombolysis, 57, 918–928. https://doi.org/10.1007/s11239-024-02998-9