Management of Acute Pulmonary Embolism With a Pulmonary Embolism Response Team

Abstract

Despite recent advances in the assessment, risk stratification, and treatment of acute pulmonary embolism (PE), it remains a leading cause of cardiovascular morbidity and mortality in the United States each year. Patient presentation and prognosis are heterogeneous, and a variety of diagnostic and therapeutic instruments have arisen to assist in providing patients with the appropriate level of care and aggressiveness of approach. Fortunately, a growing number of institutions now have pulmonary embolism response teams (PERT) that urgently assist with risk assessment and management of patients with massive and sub-massive PE. In service of providers at the point of contact with acute PE, this review aims to summarize the data pertinent to rapid risk assessment and the interpretation of diagnostics used to that end. The role of PERT and the indications for systemic fibrinolysis and invasive therapies are also discussed.

Keywords: Cardiology; Clinical Decision-Making; Echocardiography; Fibrinolysis; Patient Care Team; Pulmonary Embolism; Pulmonary Medicine; Radiology; Risk Assessment; Thrombolytic Therapy; Venous Thromboembolism.