PULMONARY EMBOLISM
DISEASE OVERVIEW
CIRCLE STRATEGY
ESC GUIDELINES
CLINICAL DATA
PULMONARY EMBOLISM
DISEASE OVERVIEW
CIRCLE STRATEGY
ESC GUIDELINES
CLINICAL DATA
Vascular Surgery / Venous Thromboembolism Portal / Pulmonary Embolism / ESC Guidelines

 

The Diagnosis and Management of Acute PE

 

 

PEs can be immediately fatal.1 However, if PE can be diagnosed and the appropriate therapy started, the mortality can be reduced from approximately 30% to less than 10%.2

The PE roadmap shown here is adapted from the European Society of Cardiology (ESC) Guidelines.3

 

Clinical Suspicion of PE

 

ESC Guidelines on Acute Pulmonary Embolism

 

Why Intervene on Intermediate-High-Risk Patients?

 

 

Various studies report the presence of right ventricular dysfunction (RVD) as a predictor of poor clinical outcomes:

  • The presence of RV hypokinesis on the baseline echo is associated with higher mortality at 2 weeks and 3 months compared to cases with no RV hypokinesis.5
  • Patients with RVD defined as RV/LV >0.9 have a greater chance of adverse events within 30 days than those with RV/LV ≤0.9.6
  • Patients with unresolved RVD are 8 times more likely to experience recurrent venous thromboembolism (VTE) than those without RVD.7†

 

Measuring RV/LV Ratio4

 
  • Apical 4-chamber view.
  • End diastolic image.
  • Centre line through interventricular septum.
  • Obtain tricuspid annular line.
  • Obtain subannular line 1cm above annular line.
  • Obtain RV and LV dimensions using endocardial borders.

 

Sample Pre and Post RV/LV Measurement Leveraging 2-Hour OPTALYSE Protocol9?

Sample Pre and Post RV/LV Measurement Leveraging 2-Hour OPTALYSE Protocol
CTA Pre PE Therapy: RV/LV Ratio: 1.516
Sample Pre and Post RV/LV Measurement Leveraging 2-Hour OPTALYSE Protocol
CTA 48 Hours Post PE Therapy: RV/LV Ratio: 0.798 2h infusion; 8mg total tpa

 

 

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