Pro/Con: Bust the Clot or Suck It Out: Controversies in Pulmonary Embolism Management
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Pulmonary, Pharmacology, Hematology, 2022
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Pulmonary embolism (PE) is an important cause of mortality. One-third of deaths are sudden, and 60% are undiagnosed before death. Recognition of PE can be challenging because symptoms and clinical signs may be nonspecific. Patients with massive PE and frank shock require urgent support. Patients with submassive PE present more of a dilemma. Patients with elevated cardiac troponin and/or right right ventricular strain on echocardiography are at higher risk of in-hospital mortality; most of them will improve with conservative therapy but some will not. Precisely how to treat these patients remains a clinical challenge. New interventional strategies with either catheter-directed therapy, mechanical fragmentation, thrombectomy, or a combination of these have been proposed, but firm data supporting a benefit in hard outcomes is currently lacking. A pro/con debate will contrast pharmacologic therapy with interventional strategies for PE. Learning Objectives: -Perform risk stratification in patients with pulmonary embolism (PE) -Select patients for anticoagulation and/or thrombolytic therapy based on risk stratification and the risks and benefits of pharmacotherapy -Select patients for mechanical therapies and choose among available options based on risks and benefits -Consider the merits of a PE response team as an institutional strategy
Meta Tag
Content Type Presentation
Knowledge Area Pulmonary
Knowledge Area Pharmacology
Knowledge Area Hematology
Knowledge Level Intermediate
Knowledge Level Advanced
Membership Level Select
Tag Pulmonary Embolism
Tag Pharmacology
Tag Coagulation
Tag Thrombolysis
Year 2022
pulmonary embolism
risk stratification
bleeding risk
catheter-directed thrombolysis
mechanical embolectomy
patient-centered outcomes


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