Submassive pulmonary embolism
Updates to Article Attributes
Body
was changed:
A submassive pulmonary embolism refers to an acute pulmonary embolism with evidence of myocardial necrosis or right ventricular dysfunction in the absence of systemic hypotension. An elevation in troponin I or T provides evidence of myocardial necrosis. Right ventricular dysfunction is defined by the presence of any of the following:
- echocardiographic evidence of right ventricular dilation or systolic dysfunction
- an RV/LV diameter ratio >0.9 on CT 4
- biomarker elevations
- brain
natiureticnatriuretic peptide (BNP) > 90 pg/mL or pro-BNP >500 pg/mL
- brain
- characteristic electrocardiographic abnormalities
- right bundle branch block (complete or incomplete)
- anteroseptal ST
-Tsegment deviation -
anteroseptal T wave
abnormalitiesinversion
Differential diagnosis
-
massive pulmonary embolism
-
acute pulmonary embolismassociated witheithersustained hypotension, bradycardia with signs of shock, or pulselesness
-
- right ventricular
dysfunctionor evidence ofmyocardialnecrosis with systemic hypotension, pulselessness or bradycardiainfarction - acute cor pulmonale
-
decompensated chronic pulmonary hypertension
- most commonly due to left sided heart disease
-<li>echocardiographic evidence of right ventricular dilation or systolic dysfunction</li>- +<li>echocardiographic evidence of right ventricular dilation or <a title="RV dysfunction" href="/articles/right-ventricular-dysfunction">systolic dysfunction</a>
- +</li>
-<li>biomarker elevations<ul><li>brain natiuretic peptide (BNP) > 90 pg/mL or pro-BNP >500 pg/mL</li></ul>- +<li>biomarker elevations<ul><li>brain natriuretic peptide (BNP) > 90 pg/mL or pro-BNP >500 pg/mL</li></ul>
-<li>right bundle branch block</li>-<li>anteroseptal ST-T wave abnormalities</li>- +<li>right bundle branch block (complete or incomplete)</li>
- +<li>anteroseptal ST segment deviation</li>
- +<li>anteroseptal T wave inversion</li>
-</ul><h4>Differential diagnosis</h4><ul><li>-<a title="Massive pulmonary embolism" href="/articles/massive-pulmonary-embolism">massive pulmonary embolism</a><ul><li>acute pulmonary embolism with either <a href="/articles/right-ventricular-dysfunction">right ventricular dysfunction</a> or evidence of myocardial necrosis with systemic hypotension, pulselessness or bradycardia</li></ul>-</li></ul>- +</ul><h4>Differential diagnosis</h4><ul>
- +<li>
- +<a href="/articles/massive-pulmonary-embolism">massive pulmonary embolism</a><ul><li>associated with sustained hypotension, bradycardia with signs of shock, or pulselesness</li></ul>
- +</li>
- +<li>right ventricular <a title="Myocardial infarction" href="/articles/myocardial-infarction">myocardial infarction</a>
- +</li>
- +<li>acute cor pulmonale</li>
- +<li>decompensated chronic <a title="Pulmonary hypertension" href="/articles/pulmonary-hypertension-1">pulmonary hypertension</a><ul><li>most commonly due to left sided heart disease</li></ul>
- +</li>
- +</ul>
Tags changed:
- echo
- pocus
Images Changes:
Image 1 Ultrasound (Subcostal 4 chamber) ( create )
Image 2 CT (C+ arterial phase) ( create )
