Summary

Venous thromboembolism is responsible for the hospitalization of more than 250,000 Americans annually and represents a significant risk for morbidity and mortality [Jaff MR et al. Circulation 2011]. Approximately 5% of pulmonary embolisms (PEs) are considered massive (systolic blood pressure <90 mm Hg or a =40 mm Hg drop in BP for >15 minutes + signs of hypoperfusion). Although not always easy to do, distinguishing between massive and nonmassive events is important. This article discusses the management of massive PE, the use of IVC filters in patients with PE, the use of new anticoagulants compare with older therapies, and the the practical use of biomarkers and scoring systems for patients with PE.