- Classification of PE severity has traditionally been based on haemodynamic stability:
Massive
- Cardiovascular compromise with a systolic blood pressure (SBP) <90 mmHg or a drop in systolic pressure of >40 mmHg
Sub-Massive
- No systemic hypotension but evidence of either RV dysfunction or myocardial necrosis
Mild / Non-Massive
- Asymptomatic or with mild symptoms and no evidence of RV dysfunction or cardiovascular compromise
- Newer classifications of severity are based upon early mortality risk (in-hospital or 30-days) using clinical, imaging, and laboratory indicators:
Early Mortality Risk
Early Mortality Risk
Risk Parameters & Scores
Risk Parameters & Scores
Risk Parameters & Scores
Risk Parameters & Scores
Early Mortality Risk
Early Mortality Risk
Shock or hypotension
PESI class III-V
Signs or RV Dysfunction on Imaging
Cardiac Laboratory Biomarkers
High
High
+
(+)
+
(+)
Intermediate
High
-
+
Both positive
Both positive
Intermediate
Low
-
+
Either one (or none) positive
Either one (or none) positive
Low
Low
-
-
-
Assessment optional but negative if assessed