Acute massive pulmonary embolism is a leading cause of death in patients admitted to the hospital
Types of pulmonary embolism
Pulmonary embolism (PE) is a condition where blood clots that originate elsewhere in the body break off and travel to the vasculature of the lungs to block the blood flow from the right side of the heart to the left side.
Pulmonary embolism can be minor when a small portion of the lung vasculature is involved, or it may be massive if the majority of the vasculature is involved and circulation is compromised by this dangerous blood clot.
Testing for pulmonary embolism
The most common pulmonary embolism test is a venous phase CT angiogram. This quick and accurate blood clot test provides all the information needed for initial pulmonary embolism treatment. Unfortunately, the need for contrast dye makes the test risky in patients with renal dysfunction (kidney dysfunction).
A VQ scan is an alternative test, but it does not distinguish between acute and chronic pulmonary embolism. An echocardiogram is important to look at the function of the right heart to see if any thrombus (blood clot) is present in the heart that could cause additional compromise to the lung circulation and may constitute an indication for emergency heart surgery.
Pulmonary embolism response team (PERT)
Time is of the essence with acute massive pulmonary embolism treatment. The management of pulmonary embolism involves multiple specialists with a wide range of expertise. The PERT is organized to simultaneously communicate to all the specialists and promptly activate the required resources to manage acutely ill heart patients.
Options include blood thinners (anticoagulation and fibrinolysis), catheter-based therapies and emergent heart surgery. We are happy to transfer patients from other institutions for these advanced therapies to treat pulmonary embolism.
CTEPH
Many patients with chronic thromboembolic pulmonary hypertension (CTEPH) are unaware they had an acute pulmonary embolism.