PulmonologyGENERAL
Pulmonary embolism risk stratification — PESI score vs simplified PESI, when to thrombolyse?
55F presents with acute onset dyspnea and pleuritic chest pain. CT-PA confirms bilateral PE with right heart strain. BP 100/68, HR 118, SpO2 88% on room air. Echo shows RV dilation and McConnell sign. Troponin mildly elevated. PESI score is 95 (Class III). She is hemodynamically borderline. Should I use PESI or sPESI to guide thrombolysis decision? What's the threshold for systemic thrombolysis vs catheter-directed therapy?