Risk adapted management of acute pulmonary embolism in women

Acute pulmonary embolism (PE) represents the third most common cause of cardiovascular death worldwide. Clinical practice guidelines recommend prompt risk stratification of patients with acute PE. Prognostication may accurately identify: 1) hemodynamically unstable (i.e., high-risk) patients with PE, who might benefit from recanalization therapies (i.e., thrombolysis, embolectomy); 2) intermediate- to high-risk patients with PE, who might require monitoring and recanalization procedures if early hemodynamic decompensation occurs; and 3) low-risk patients with PE, who might benefit from an abbreviated hospital stay or outpatient therapy. A fourth group of patients should not undergo escalated or home therapy (intermediate- to low-risk PE). Studies of patients with proven acute PE have shown conflicting data regarding the association between sex and presentation and short-term clinical course in patients with acute symptomatic PE. Therefore, at this time sex differences should not dictate different approaches to prognostication and management.