What Is a Submassive Pulmonary Embolism

Submassive (or intermediate-risk) PE refers to those patients with acute PE without systemic hypotension but with evidence of either right ventricle (RV) dysfunction or myocardial necrosis.

What is the difference between massive and Submassive PE?

High-risk submassive PE: Hemodynamically stable patients who nonetheless have elevated mortality. They merit ICU admission and consideration for advanced therapies. Non-crashing massive PE: Patients with hypotension who stabilize well on low-dose vasopressor. These patients need ICU admission and advanced therapies.

How do you treat a Submassive PE?

The US Food and Drug Administration has approved tPA 100 mg administered as a continuous intravenous infusion over a 2-hour period for treatment of acute massive PE. Nevertheless, tPA is often used off-label to treat submassive PE.