PE Classification

Question 1

How does a patient present if they are diagnosed with massive PE?

Answer 1

Systolic BP<90 mmHg or a decrease of 40 mmHg from baseline
Patient that requires vasopressors
Patient that is pulseless

Question 2

How does a patient present if they are diagnosed with submassive PE?

Answer 2

Right ventricular strain: on echo imaging, positive troponin, OR increased BNP

Question 3

How does a patient present if they are diagnosed with low risk PE?

Answer 3

PE that does not meet the criteria of massive or submassive PE.

Question 4

True or false: A patient who presents with low risk PE still had a PE.

Answer 4

TRUE

Question 5

True or false: Submassive and massive PE are classified based on the size of the embolism.

Answer 5

FALSE, the classification of PE correlates with the symptoms

Question 6

How do we treat low risk PE?

Answer 6

Therapeutic anticoagulation (same as DVT!)

Question 7

How do we treat a patient who presents with submassive PE?

Answer 7

Catheter-directed thrombolytics, then therapeutic anticoagulation (GENERALLY)

Question 8

How do we treat a patient who presents with massive PE?

Answer 8

IV thrombolytics, then therapeutic anticoagulation (GENERALLY)

Question 9

Why do we see positive troponin in a patient who has submassive PE?

Answer 9

Sign of cardiac necrosis.

Question 10

Why do we see increased BNP in a patient who presents with submassive PE?

Answer 10

The right side of the heart is stretching and trying to overcome the embolism or obstruction. The ventricular stretch results in increased BNP.

Question 11

True or False:

You can use a submissive PE if there are no ECHO imaging, a negative troponin, and positive BNP

Answer 11

False