Case of the Month #7 - pulmonary embolism

Published 03/02/2022

What investigations may help prognosticate mortality in pulmonary embolism?

  • Troponins:  This is a sensitive and specific biomarker for irreversible myocardial injury.  Increased levels have been associated with increased short term mortality risk in acute PE.   
  • NT pro-BNP:  BNP shows correlation with right ventricular (RV) dysfunction in acute PE and is also associated with increased short term mortality.   
  • Lactate:  Plasma levels > 2mmol/L can predict PE related complications in high risk patients. 
  • Transthoracic echocardiography (TTE):  Findings of RV overload and dysfunction have been associated with increased short term mortality and PE-related complications.  If accompanied with low cardiac output state, acute RV failure is the leading cause of death in patients with massive PE.