Risk Stratification and Management of Intermediate-Risk Acute Pulmonary Embolism

Autor: Nichole Brunton, Robert McBane, Ana I. Casanegra, Damon E. Houghton, Dinu V. Balanescu, Sumera Ahmad, Sean Caples, Arashk Motiei, Stanislav Henkin
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Clinical Medicine, Vol 13, Iss 1, p 257 (2024)
Druh dokumentu: article
ISSN: 2077-0383
DOI: 10.3390/jcm13010257
Popis: Pulmonary embolism (PE) is the third most common cause of cardiovascular death and necessitates prompt, accurate risk assessment at initial diagnosis to guide treatment and reduce associated mortality. Intermediate-risk PE, defined as the presence of right ventricular (RV) dysfunction in the absence of hemodynamic compromise, carries a significant risk for adverse clinical outcomes and represents a unique diagnostic challenge. While small clinical trials have evaluated advanced treatment strategies beyond standard anticoagulation, such as thrombolytic or endovascular therapy, there remains continued debate on the optimal care for this patient population. Here, we review the most recent risk stratification models, highlighting differences between prediction scores and their limitations, and discuss the utility of serologic biomarkers and imaging modalities to detect right ventricular dysfunction. Additionally, we examine current treatment recommendations including anticoagulation strategies, use of thrombolytics at full and reduced doses, and utilization of invasive treatment options. Current knowledge gaps and ongoing studies are highlighted.
Databáze: Directory of Open Access Journals