In the context of suspected right ventricular infarct, which hemodynamic pattern is most characteristic?

• A. Hypotension with clear lungs
• B. Hypotension with pulmonary edema
• C. Hypertension with clear lungs
• D. Normal hemodynamics

Answer: (A)

In a right ventricular infarct, the heart’s ability to pump forward is compromised, so overall cardiac output falls and blood pressure drops. Because the left ventricle and the pulmonary circulation aren’t congested, the lungs aren’t edematous and stay clear on examination. This combination—low blood pressure with clear lungs—is the hallmark pattern you’d expect with an isolated RV infarct. You may also see signs of venous congestion, like an elevated jugular venous pressure, due to the failing right ventricle, but pulmonary edema is not present because the left side isn’t failing.