Massive pulmonary embolism heart failure: A review of clinical status and meta-analyses of clinical scoring system and D-dimer, and thrombolytic and anticoagulation therapies

Heart failure secondary to massive pulmonary embolism (MPE) is a commonly underdiagnosed and potentially life-threatening complication of deep vein thrombosis (DVT), with death usually occurring due to right ventricular failure in the setting of sustained hypotension and cardiogenic shock. Early diagnosis and prompt institution of PE specific therapy greatly improves clinical management of MPE. However, MPE presents with non-specific signs and symptoms that may delay diagnosis and institution of definitive treatment. Even with the availability of pharmacologic, catheter-based and surgical intervention, mortality remains high. This review paper discusses the current understanding of MPE from data from recent studies and registries as well as highlights areas requiring clarification by ongoing and future research.