Case of the Month #7 - pulmonary embolism

Published 03/02/2022

How can acute pulmonary embolism be classified?

  • Massive PE:  Acute PE with persistent hypotension (systolic BP <90mmHg for at least 15 minutes or requiring vasopressor/inotropic support) that is not due to another cause. 
  • Submassive PE:  Acute PE with signs of right ventricle dysfunction and/or myocardial ischaemia without systemic hypotension. 
  • Low risk PE:  Acute PE with normal cardiac biomarker levels, right ventricular function, and blood pressure. 

Alternatively, the Pulmonary Embolism Severity Index (PESI) can be used to identify low, moderate, and high risk patients.  These categories correlate with low risk, submassive, and massive PE respectively. 

This patient had a massive PE.