In this episode, Dr. Kristen Adorno takes us through the urgent management of acute right heart failure, focusing on the "RV death spiral" caused by massive pulmonary embolism. Recorded at the ResusEM6: The Broken Heart Conference, Dr. Adorno provides a step-by-step guide to resuscitating these critically ill patients, from avoiding common pitfalls like unnecessary intubation to the strategic use of vasopressors and ECMO. Her practical, pathophysiology-driven approach is designed to empower clinicians to handle these challenging cases with confidence. This episode is packed with essential insights for anyone involved in emergency and critical care.