Working out helps me sleep. After recording this, I am heading to the gym to work the lower body.

Why tell you this? Because when I think about the right ventricle and pulmonary embolism, I sometimes think about squats.

So keeping with that theme, it is leg day. And know this, gym, friends, don't let friends skip leg day.

And once you are a decade or so into the sport, you're putting big weights on the squat bar,

not just a couple of 45-pound plates on both sides, but real big weight.

And you are going to bust out a big set.

In fact, this day you are pumped and you are going to do 10 big heavy sets of eight squats each and ain't nobody is getting on that squat

rack until you have handled your business. And despite some really big blood pressure elevations with all that weight, somehow your left ventricle handles it.

You read these studies and articles where the systolic blood pressures are in the 250 to 320 range during heavy lifts involving the lower body and core muscles.

And maybe it's not a great example, since it is a transient stress on the left ventricle,

but as many of my listeners know, I am a fan of natural bodybuilding and how else am I going

to artificially squeeze lifting weights into a lecture on pulmonary embolism?

Remember, folks, the things that don't

lie are drunk friends, little kids, and short shorts. Get your leg day done at the gym at a minimum

once a week. And if you can easily sit down on the toilet, the day after a leg day workout without

severe soreness, you really didn't have a leg day. Was that really my point of all this?

No, I just get distracted easily. My bigger point is that the left ventricle is pretty sweet and that

it can somewhat adapt to high pressure changes for a while. You know what isn't that great in handling

a new high pressure situation? You guessed it,

the right ventricle. The right ventricle does not adapt well to acute high pulmonary artery

pressures, such as from a large pulmonary embolism burden. Blood clots release factors that cause vasoconstriction beyond the clot burden itself,

so it can turn into a disagreeable situation quickly.

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