Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism.

By Kenneth E. Wood. Chest, 2002

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In Silico Modeling of Magnetic Resonance Flow Imaging in Complex Vascular Networks (2014, background): “Such vessel perturbations can lead to many serious consequences, such as cerebral hemorrhage [6], liver ischemia with hepatic insufficiency [7], or thromboembolic pulmonary embolism [8].”
Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism (2008, background): “The key consequences of a pulmonary thromboembolic episode are haemodynamic.(32) Large and/or multiple emboli might abruptly increase pulmonary vascular resistance to a level of afterload which cannot be matched by the right ventricle (RV).”
Pulmonary arterial hypertension (2013, background): “Norepinephrine acting primarily through B1-adrenergic receptors has a positive inotropic effect on the myocardium.(171,172,221) A central intravenous line or pulmonary artery catheter and an arterial cannula are useful to monitor hemodynamics and to administer medications.”
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock* (2006, background): “In the clinical context, a “golden hour” has been described for therapy of hypovolemic shock due to trauma (27), cardiogenic shock due to myocardial infarction (28), and, most recently, obstructive shock due to massive pulmonary embolus (29).”