Deep Dive MW R16

Diagnosing PE:











Step 1: Consciously consider the diagnosis











Step 2: Risk Stratify into low, intermediate, and high risk











Step 3: Choose appropriate testing based on pre-test probability











Classification of PE














* High Risk/Massive PE: Hemodynamic Instability











* Intermediate Risk/Submassive PE: Right Heart Strain without instability ; or PESI Class 3+











* Low Risk/Non-Massive PE: Everything else (no instability, no heart strain, PESI Class 1-2)














Treatment of PE














* High Risk/Massive PE: Thrombolytics and often thrombectomy











* Intermediate Risk/Submassive PE: Heparin and sometimes intervention











* Low Risk/Non-Massive PE: Either discharge with DOAC or admit with heparin