The right ventricle (RV), due to its morphologic and physiologic differences, is susceptible to sudden increase in RV afterload, as noted in patients with acute pulmonary embolism (PE). Functional impairment of RV function is a stronger presage of adverse outcomes in acute PE than the location or burden of emboli. While current iterations of most clinical prognostic scores do not incorporate RV dysfunction, advancements in imaging have enabled more granular and accurate assessment of RV dysfunction in acute PE. RV enlargement and dysfunction on imaging is noted only in a subset of patients with acute PE and is dependent on underlying cardiopulmonary reserve and clot burden. Specific signs like McConnell's and “60/60” sign are noted in less than 20% of patients with acute PE. About 2% of patients with acute PE develop chronic thromboembolic pulmonary hypertension, characterized by continued deterioration in RV function in a subset of patients with a continuum of RV function from preserved to overt right heart failure. Advances in molecular and other imaging will help better characterize RV dysfunction in this population and evaluate the response to therapies.

右心室 (RV) 由于其形态学和生理学差异，容易受到 RV 后负荷突然增加的影响，正如急性肺栓塞 (PE) 患者所指出的那样。与栓子的位置或负担相比，RV 功能的功能损害是急性 PE 不良后果的更强烈预兆。虽然目前大多数临床预后评分的迭代不包括右心室功能障碍，但影像学的进步已经使急性 PE 中右心室功能障碍的评估更加精细和准确。仅在一部分急性 PE 患者中发现 RV 扩大和影像学功能障碍，并且取决于潜在的心肺储备和血块负荷。不到 20% 的急性 PE 患者会出现诸如 McConnell 征和“60/60”征等特定体征。大约 2% 的急性肺栓塞患者发展为慢性血栓栓塞性肺动脉高压，其特征是右心室功能持续恶化的一部分患者的右心室功能持续恶化，从保留到明显的右心衰竭。分子和其他成像技术的进步将有助于更好地表征该人群的 RV 功能障碍并评估对治疗的反应。