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Should They Stay or Should They Go?Low-Risk Acute Pulmonary Embolism: Identification of Low-Risk Patients With Acute Pulmonary Embolism Who Can Be Safely Treated Outside of the Hospital

Lisa K. Moores, MD, FCCP
Author and Funding Information

From the Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine.

CORRESPONDENCE TO: Lisa K. Moores MD, FCCP, The Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, 4301 Jones Bridge Rd, Bethesda, MD 20814; e-mail: lisa.moores@usuhs.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(3):589-590. doi:10.1378/chest.14-2170
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Extract

Treatment of patients with VTE, whether determining setting or intensity of care or duration of secondary prevention, is shifting from a disease-specific to an individualized approach. Current evidence-based treatment guidelines are fairly straightforward for some patients, such as those who present with isolated DVT or hemodynamic shock or sudden cardiac death.1 There is growing recognition, however, that patients with acute pulmonary embolism (PE) who are hemodynamically stable are not homogeneous. Some of these patients, particularly those with evidence of higher clot burden and right ventricular strain, might benefit from more aggressive care, to include ICU admission and the consideration of thrombolytic therapy. Other patients may suffer minimal physiologic consequences from the acute clot and could potentially be treated in the outpatient environment.2

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