Since the right ventricle has a remarkable tendency to recover function rapidly, diagnostic tests are most reliable when performed soon after presentation. Clinical suspicion and a careful physical examination demonstrating the signs are the first step.

• Ischemia or infarction of the right ventricle results in decreased right ventricular compliance, reduced filling, and diminished right-sided stroke volume with concomitant right venticular dilation and alteration in septal curvature. ^[1] These hemodynamic and geometric changes lead to decreased left ventricular filling and contractile function with a concomitant fall in cardiac output. ^{[2] [3] [4] [5] [6] [7]} The net effect is that left-sided filling pressures may be below normal despite clinical signs of high pressure on the right side. This disparity has important implications for therapy.