Key result
Systemic thrombolytics play a critical role in acute high-risk PE management but remain underutilized.
Why the study?
High-risk pulmonary embolism is associated with severe hemodynamic instability and high mortality, requiring an updated understanding of management strategies and clinical approaches in acute emergency settings.
This review emphasizes the critical role and underutilization of systemic thrombolytics in the acute management of high-risk pulmonary embolism, aligning with current ESC and AHA guidelines.
Alerts clinicians to thrombolytic underutilization in high-risk PE; leaves open prospective studies on adoption barriers.
Background: High-risk pulmonary embolism (PE), encompassing a small but critical subset of cases, is associated with severe hemodynamic instability and high mortality rates. Representing 5–10% of all PE cases, high-risk PE is a leading cause of cardiovascular mortality, contributing to significant patient morbidity and mortality. Aim: This review aims to elucidate the management strategies and clinical approaches for high-risk PE, particularly in acute emergency settings. It seeks to provide a comprehensive overview of diagnostic and therapeutic strategies based on current guidelines. This review aimed to gain insights about treatment and management of PE via EMS and pharmacists. Methods: A thorough literature search was conducted using PubMed and Google Scholar, focusing on high-risk pulmonary embolism from the inception of these databases until October 1, 2023. The review included 147 articles comprising case reports, clinical trials, and systematic reviews. The search emphasized high-quality studies and guidelines, including those from the European Society of Cardiology (ESC) and the American Heart Association (AHA). Results: The review highlights the critical role of systemic thrombolytics (ST) in managing high-risk PE, despite their underutilization. It discusses the ESC and AHA guidelines for classifying PE risk and outlines the pathophysiology of right ventricular failure.
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Alsulami et al. (2024) conducted a review in High-risk pulmonary embolism. Systemic thrombolytics was evaluated. Systemic thrombolytics play a critical role in managing high-risk pulmonary embolism in acute settings, though they remain underutilized based on a review of 147 articles.
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