Pulmonary Embolism, Acute

# Pulmonary Embolism (Submassive)
sPESI *** BOVA ***. Pt presents with symptomatic but hemodynamically stable PE with biomarker or imaging findings of right ventricular strain. In these patients, anticoagulation is the mainstay of treatment, although local thrombolytics are rarely indicated. Unclear trigger, as pt is without past hx suggestive of hypercoagulable state or recent travel.
- Anticoagulation: ***
- CPO, Tele
- Trop, BNP, CBC, BMP, INR
- EKG, CT PE. Consider TTE
- Ensure outpatient age appropriate cancer screening
- Consider outpatient hypercoagulability studies
- If  clinical deterioration, contact IR/PE team regarding thrombolytics vs thrombectomy

# Pulmonary Embolism (Massive)
Patient presents with symptomatic and hemodynamically unstable PE (SBP <90 for greater than 15 minutes) with biomarker or imaging findings of right ventricular strain. Contact IR/PE team regarding local vs systemic thrombolytics. Unclear trigger, as pt is without past hx suggestive of hypercoagulable state or recent travel.
- Start Heparin gtt vs Enoxaparin while awaiting IR decision
- CPO, Tele, ICU
- Trop, BNP, CBC, BMP, INR, ABG
- EKG, CT PE, TTE
- Ensure outpatient age appropriate cancer screening
- Consider outpatient hypercoagulability studies