Submassive pulmonary embolism

Crit Care Clin. 2014 Jul;30(3):447-73. doi: 10.1016/j.ccc.2014.03.006.

Abstract

Pulmonary embolism (PE) is a common diagnosis in critical care. Depending on the severity of clot burden, the clinical picture ranges from nearly asymptomatic to cardiovascular collapse. The signs and symptoms of PE are nonspecific. The clinician must have a high index of suspicion to make the diagnosis. PE is risk stratified into 3 categories: low-risk, submassive, and massive. Submassive PE remains the most challenging with regard to initial and long-term management. Little consensus exists as to the appropriate tests for risk stratification and therapy. This article reviews the current literature and a suggested approach to these patients.

Keywords: Intermediate-risk pulmonary embolism; Pulmonary embolism; Right ventricular dysfunction; Risk stratification; Submassive; Thrombolysis.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / drug therapy*
  • Risk Factors
  • Thrombolytic Therapy / methods*
  • Ventricular Dysfunction, Right / complications
  • Ventricular Dysfunction, Right / diagnosis*
  • Ventricular Dysfunction, Right / drug therapy*

Substances

  • Fibrinolytic Agents