In-Hospital Mortality Was Similar in Patients with Saddle vs. Nonsaddle Pulmonary Emboli

Saddle pulmonary emboli (PE) are clots that straddle the bifurcation of the left and right main pulmonary arteries. Although saddle PE are radiographically impressive, not all patients with these findings demonstrate hemodynamic instability, and studies have shown mixed results with respect to early mortality. Mayo Clinic investigators matched 187 patients with saddle PE and 187 controls with nonsaddle PE, based on age and simplified Pulmonary Embolism Severity Index (sPESI). The groups had similar proportions of patients with malignancy, history of PE, and recent surgery or immobilization.

Patients with saddle PE were more likely to have elevated troponin values, to have echocardiographic right ventricular dysfunction, and to be classified …