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ClearRounds Health · Cardiology · Quick Reference
PE / DVT
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Vascular & ThromboembolicIntermediateIn progressOne-page PDF
Risk stratification, anticoagulation basics, submassive/massive PE, RV strain, thrombectomy/thrombolysis considerations, and follow-up.
Covers both PE and DVT.
Last reviewed
Pending initial clinical review
Sources / guidelines to verify
- CHEST VTE / Antithrombotic Therapy Guideline
- ESC Acute Pulmonary Embolism Guideline (verify against local pathway)
Disclaimer: Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.
One-page reference
Draft content pending the site owner’s clinical review. Verify against the sources above and local protocol before clinical use.
1
What it is / why it matters
- Venous thromboembolism: DVT (usually leg) ± pulmonary embolism.
- Risk-stratify PE by hemodynamics and RV strain — that drives therapy.
2
Key diagnostic clues
- DVT: unilateral leg swelling, pain, warmth.
- PE: dyspnea, pleuritic chest pain, tachycardia, hypoxia, syncope.
- Use Wells score; D-dimer to rule out in low-probability patients.
3
Initial workup
- CTPA (or V/Q) for PE; compression ultrasound for DVT.
- ECG (sinus tachycardia; occasionally S1Q3T3), troponin and BNP for RV strain.
- Bedside echo for RV assessment in unstable patients.
4
Management framework
Anticoagulation
- DOAC first-line for most; LMWH lead-in for dabigatran/edoxaban
- Cancer-associated VTE: DOAC or LMWH, longer duration
- Minimum 3 months; longer if unprovoked or persistent risk
PE risk stratification
- Massive (hypotension): systemic thrombolysis or embolectomy
- Intermediate (RV strain, normotensive): anticoagulate + monitor; consider catheter-directed therapy / PERT
- Low-risk: anticoagulate; consider outpatient management
- IVC filter only when anticoagulation is contraindicated.
5
Red flags / escalate now
- Hypotension/shock (massive PE) → activate the PE response team (PERT); consider thrombolysis.
- Severe hypoxia, syncope, or rising troponin / RV failure.
6
Follow-up / monitoring
- Reassess provoking factors and bleeding risk; decide on duration at ~3 months.
- Consider thrombophilia/cancer workup if unprovoked.
- Persistent dyspnea months later → screen for CTEPH with a V/Q scan.
7
Clinic pearls
- Normotensive + RV strain = intermediate-risk — watch closely.
- Don’t forget post-PE syndrome and CTEPH in lingering dyspnea.
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