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Massive pulmonary embolism with haemodynamic collapse.

M G Caleb1

  • 1National Heart Centre, Singapore. mcgeorge88@hotmail.com

Singapore Medical Journal
|May 15, 2002
PubMed
Summary

Massive pulmonary embolism with shock is often fatal. Early diagnosis, thrombolysis, and surgical referral are crucial for improving outcomes in these critical cases.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Emergency Medicine

Background:

  • Massive pulmonary embolism (PE) with shock is a life-threatening condition with high mortality rates.
  • Despite medical advancements, outcomes for patients experiencing haemodynamic collapse due to PE remain poor.

Purpose of the Study:

  • To review outcomes of patients with massive PE requiring emergent surgery.
  • To identify factors influencing survival in this high-risk patient group.

Main Methods:

  • Retrospective analysis of twelve massive PE cases requiring emergent surgery over seven years.
  • Evaluation of patient demographics, clinical presentation, treatment strategies, and outcomes.

Main Results:

  • Five out of twelve patients (41.7%) experienced haemodynamic collapse and all died.
  • Patients who did not experience haemodynamic collapse had better survival rates.
  • Successful salvage was challenging in cases with severe haemodynamic compromise.

Conclusions:

  • Rapid diagnostic confirmation is essential for timely intervention in massive PE.
  • Appropriate thrombolysis and prompt referral to cardiothoracic surgery are critical for improving survival.
  • Aggressive management strategies, including surgical intervention, are necessary but outcomes remain guarded in patients with shock.

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