Submassive Pulmonary Embolism

Am J Respir Crit Care Med. 2018 Sep 1;198(5):588-598. doi: 10.1164/rccm.201711-2302CI.


Pulmonary embolism (PE) presents a spectrum of hemodynamic consequences, ranging from being asymptomatic to a life-threatening medical emergency. Management of submassive and massive PE often involves clinicians from multiple specialties, which can potentially delay the development of a unified treatment plan. In addition, patients with submassive PE can deteriorate after their presentation and require escalation of care. Underlying comorbidities such as chronic obstructive pulmonary disease, cancer, congestive heart failure, and interstitial lung disease can impact the patient's hemodynamic ability to tolerate submassive PE. In this review, we address the definitions, risk stratification (clinical, laboratory, and imaging), management approaches, and long-term outcomes of submassive PE. We also discuss the role of the PE response team in management of patients with PE.

Keywords: catheter-directed thrombolysis; intermediate pulmonary embolism; pulmonary embolism response team; pulmonary embolism risk stratification; submassive pulmonary embolism.

Publication types

  • Review

MeSH terms

  • Computed Tomography Angiography
  • Embolectomy
  • Humans
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / physiopathology
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / physiopathology*
  • Pulmonary Embolism / therapy
  • Severity of Illness Index
  • Vena Cava Filters