Key result
Central PE is linked to greater RV stress but carries similar mortality across emboli locations.
Why the study?
Diagnosing pulmonary embolism in hemodynamically stable patients is challenging, and the relationship between emboli location and prognosis remains unclear.
Emboli location and thrombus size in pulmonary embolism significantly influence clinical symptoms and prognosis, highlighting the importance of risk stratification.
Mortality equivalence across PE locations cautions against location-driven escalation; leaves open refined stratification incorporating RV strain.
INTRODUCTION: Pulmonary embolism (PE) is a widespread disorder, which appears as a result of closure or restriction of main pulmonary artery or its branches and is often associated with deep vein thrombosis (DVT).The severity and clinical picture is frequently erratic and what is worrying it is a major cause of hospitalization and mortality in Europe. OBJECTIVE: The mainpurpose of our study was to demonstrate meaning of emboli location in prognosis,favour risk factors which could be overlooked by clinicians and help to avoid further misdiagnosis. ABBREVIATED DESRCIPTION OF THE STATE OF KNOWLEDGE:We highlighted the importance of defining a genetic profile, personal and family history of VTE, especially in patients with atypical pulmonary symptoms. Moreover, the awareness of possible occurring PE among children,during serious infections or in patients with malignancy is still insufficient. Furthermore, according our analysis clinical symptoms in patients with pulmonary embolism are undoubtedly influenced by the location.The more massive the thrombus appears, the more serious consequences can be expected for the patient.Along with the size of the thrombus, the risk of its complications increases because of haemodynamic changes. SUMMARY:Diagnosing of pulmonary embolism in hemodynamically stable patients is still challenging for clinicians. There were many attempts to find significant and unmistakeable relationship between emboli location in pulmonary vasculature and prognosis.That knowledge could be helpful for clinicians in setting accurate diagnosis, implementing appropriate treatment and avoid possible life-threatening consequences.Risk stratification is crucial to the management and prognosis of patients with acute PE.
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Komisarczuk et al. (2020) conducted a review in Pulmonary embolism. Emboli location and risk factors was evaluated. The review indicates that while central pulmonary embolism is associated with greater right ventricular stress, mortality rates are similar across central, segmental, and sub-segmental emboli locations.
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