right ventricular strain

The right ventricle is built for gentle, low-pressure work, pushing blood through the easy circuit of the lungs. Right ventricular strain is the stress this chamber suffers when it is suddenly forced to pump against much higher pressure than it is used to, like a small motor abruptly asked to haul a load far beyond its design. The thin-walled right ventricle does not tolerate sudden overload well.

In pulmonary vascular disease the commonest trigger is a large pulmonary embolism, which abruptly raises the resistance the right ventricle must overcome. The chamber dilates and its wall tension rises, its blood supply can fall behind its needs, and its pumping begins to fail. Because the right and left ventricles share a wall, a swelling right ventricle can also crowd the left, reducing the body's overall blood output.

Signs of strain are looked for because they mark a higher-risk situation needing closer attention. Echocardiography may show an enlarged, poorly contracting right ventricle; the electrocardiogram may show characteristic patterns; and blood markers of heart strain may rise. In acute pulmonary embolism, evidence of right ventricular strain helps decide whether anticoagulation alone is enough or more aggressive treatment is warranted.