Pulmonary Embolism (Deep Dive MW R16)

Diagnosing PE:

Step 1: Consciously consider the diagnosis

Step 2: Risk Stratify into low, intermediate, and high risk

Step 3: Choose appropriate testing based on pre-test probability

Classification of PE

* High Risk/Massive PE: Hemodynamic Instability

* Intermediate Risk/Submassive PE: Right Heart Strain without instability ; or PESI Class 3+

* Low Risk/Non-Massive PE: Everything else (no instability, no heart strain, PESI Class 1-2)

Treatment of PE

* High Risk/Massive PE: Thrombolytics and often thrombectomy

* Intermediate Risk/Submassive PE: Heparin and sometimes intervention

* Low Risk/Non-Massive PE: Either discharge with DOAC or admit with heparin