Stable Patients with RV Enlargement and PE: Thrombolyze or Not?

In stable patients with PE, radiographic evidence of right-ventricular enlargement alone did not affect prognosis adversely or indicate a need for thrombolytic therapy.

Thrombolytic therapy for pulmonary embolism (PE) in patients with evidence of right-ventricular (RV) dilatation, but without shock, is controversial. Previous studies have yielded mixed results for PE-related mortality, all-cause mortality, and in-hospital adverse events in patients who were treated with anticoagulants alone versus those who were treated with thrombolytic agents.

In this retrospective evaluation of patients who were enrolled in the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) study, researchers compared outcomes of stable patients with or without RV enlargement (defined as an RV to left-ventricular end-diastolic diameter ratio >1, measured on transverse images of contrast-enhanced multidetector co…

Reviewing Author

Aaron J. Calderon, MD, FACP

Disclosures

EquityAbbott; Medtronic; Merck; Pfizer; CVS Health Corp.; Bristol Myers Squibb

Aaron J. Calderon, MD, FACP

Disclosures

EquityAbbott; Medtronic; Merck; Pfizer; CVS Health Corp.; Bristol Myers Squibb