PDF(Pubmed)
Abstract：
Massive pulmonary embolism (MPE) is a serious condition affecting the pulmonary arteries and is difficult to diagnose, triage, and treat. The American College of Chest Physicians (AHA) and the European Society of Cardiology (ESC) have different classification approaches for PE, with the AHA defining three subtypes and the ESC four. Misdiagnosis is common, leading to delayed or inadequate treatment. The incidence of PE-related death rates has been increasing over the years, and mortality rates vary depending on the subtype of PE, with MPE having the highest mortality rate. The current definition of MPE originated from early surgical embolectomy cases and discussions among experts. However, this definition fails to capture patients at the point of maximal benefit because it is based on late findings of MPE. Pulmonary Embolism Response Teams (PERTs) have emerged as a fundamental shift in the management of MPE, with a focus on high-risk and MPE cases and a goal of rapidly connecting patients with appropriate therapies based on up-to-date evidence. This review highlights the challenges in diagnosing and managing MPE and emphasizes the importance of PERTs and risk stratification scores in improving outcomes for patients with PE.
摘要：
大量肺栓塞（MPE）是影响肺动脉的严重疾病，难以诊断，分诊,和治疗。美国胸科医师学会（AHA）和欧洲心脏病学会（ESC）对PE有不同的分类方法，与AHA定义三个亚型和ESC四个。误诊很常见,导致延迟或不充分的治疗。多年来，与PE相关的死亡率一直在增加，死亡率因PE的亚型而异，MPE死亡率最高。MPE的当前定义源于早期外科取栓病例和专家之间的讨论。然而,由于该定义是基于MPE的晚期发现,因此无法将患者纳入最大获益点.肺栓塞反应小组(PERT)已经成为MPE管理的一个根本性转变。重点关注高危和MPE病例，目标是根据最新证据迅速将患者与适当的治疗方法联系起来。这篇综述强调了诊断和管理MPE的挑战，并强调了PERT和风险分层评分在改善PE患者预后方面的重要性。
