Management of Shock in Patients With Pulmonary Embolism-Normotensive Does Not Mean Low Risk: Insights from the FLASH Registry, Dr. Sripal Bangalore

Normotensive Does Not Mean Low Risk: Insights from the FLASH Registry, Dr. Sripal Bangalore

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Video Summary

The speaker discusses that normal blood pressure in pulmonary embolism (PE) patients does not imply low risk. A 45-year-old woman developed a saddle PE with right heart strain but stable blood pressure. PE causes increased right ventricular afterload leading to shock, often starting as normotensive shock where blood pressure remains normal due to compensation. About one-third of intermediate-risk PE patients have normotensive shock, identified by the Composite Pulmonary Embolism Shock (CPES) score, which considers clot burden, RV strain markers, DVT presence, and tachycardia. High CPES scores predict poor outcomes; thus, stable blood pressure alone should not delay aggressive management.

Keywords

Pulmonary Embolism

Normotensive Shock

Right Ventricular Strain

Composite Pulmonary Embolism Shock Score

Intermediate-risk PE