PULMONARY EMBOLISM-CLINICAL

SUMMARY

1. Clinical findings are nonspecific; sudden onset dyspnea, pleuritic chest pain & tachypnoea are most common.

2. Hemoptysis, pleuritic chest pain are assoc. with lung infarction.

3. PE can be risk stratified based on hemodynamic stability & sPESI, FAST & BOVA scores.

PE RISK STRATIFICATION
4. High-risk PE: cardiac arrest, obstructive shock, persistent hypotension (SBP < 90 mmHg) not attributable to sepsis, hypovolemia, or arrhythmia (ERS 2019 guideline).

5. Intermediate-risk PE: hemodynamically stable patient who has severity scores considered as intermediate risk based on hemodynamics, trop leak & RV dysfunction noted on TTE.

6. Low-risk PE: hemodynamically stable PE with no features of RV dysfunction.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].