Staging of pulmonary embolism (LE) according to Grosser.
| Severity I moderately severe LE | Severity II severe LE | Severity III massive LE | Severity IV fulminant LE | |
| Clinical symptoms | Discrete (sudden, short-term onset of dyspnea (shortness of breath), hyperventilation, anxiety, and dizziness), clinically silent in 80% | Acute dyspnea, tachypnea (respiratory rate: > 20/min), tachycardia (heart beats: > 100 beats/min), chest pain/chest pain (pleural rubbing), syncope (brief loss of consciousness) | In addition to severity II: cyanosis, rales (RGs) over the affected lung segment as an indication of incipient infarction (local deficiency of blood – and consequently oxygen – due to venous vascular occlusion) – increasingly ECG changes; symptoms of shock | Cardiogenic shock (shock due to pumping failure of the heart); risk of cardiovascular arrest |
| Arterial blood pressure | Normal | possibly slightly ↓ | ↓ | RR (syst) < 100 mmHg |
| Vascular occlusion | peripheral branches | Segmental arteries | Pulmonary artery branch | Pulmonary main trunk or multiple lobe arteries |
| Lethality (mortality) | Normal | < 25 % | > 25 % | > 50 % |
Risk classification of patients with pulmonary embolism.
Legend
- ATroponin I/T or natriuretic peptide.
- PESI = pulmonary embolism severity index, sPESI=simplified PESI,
- RV = right ventricular, CT = computed tomography, TTE = transthoracic echocardiography.
- + positive, present, applicable;
- (+) not necessary for definition, but in calculation, determination positive, present, applicable.
Recurrence risk (risk of recurrence) in the long-term course (Modified by).
| Estimated risk of long-term recurrence | Risk factor category for index LE | Examples |
| Low (<3% per year) | Transient (temporary) or reversible factor associated with >10-fold increase in risk for LE (“major factor”) | Instead occurred on in hospital |
| Trauma with fractures (broken bones) | ||
| Surgery with general anesthesia > 30 min | ||
| Medium (3-8% per year) | Transient or reversible factor associated with <10-fold increase in risk for LE (“minor factor”) | Contraception (pregnancy prevention). |
| Pregnancy | ||
| Long-haul flight | ||
| Non-malignant persistent factors | Inflammatory bowel disease (IBD). | |
| Active autoimmune disease | ||
| No triggering factor identifiable | – | |
| High (> 8 % per year) | – | Active cancer |
| At least one prior thromboembolic disease Absence of a definite triggering agent | ||
| Antiphospholipid syndrome (APS) |
