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===[[Pulmonary Embolism]] Categorization<ref>Jaff MR et al. Management of massive and submassive pulmonary embolism, ileofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011 Apr 26;123(16):1788-830. doi: 10.1161/CIR.0b013e318214914f. Epub 2011 Mar 21</ref>===
====Massive: High-risk====
Hemodynamically unstable with symptoms of shock
*ACCP 2016 CHEST Guidelines: Sustained hypotension ONLY criteria (systolic BP <90 for at least 15min or requiring inotropic support)
*Previous definitions (e.g. AHA 2011) include cardiac arrest/pulselessness or persistent profound bradycardia (HR <40 with signs of shock)

====Submassive: Intermediate-risk====
Right ventricular dysfunction (RVD) and/or myocardial necrosis in the absence of persistent hypotension or shock (SBP >90)<ref>Martin C et al. Systemic thrombolysis for pulmonary embolism: a review. P T. 2016 Dec; 41(12):770-775 </ref>
*RV dysfunction
**RV dilation or dysfunction on TTE
***"D Sign" on bedside echo (LV takes on a "D" shape due to RV dilation)
**RV dysfunction on CT defined as RV/LV ratio >0.9<ref>Becattini C et al. Multidetector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test. Eur Heart J. 2011 Jul;32(13):1657-63. doi: 10.1093/eurheartj/ehr108. Epub 2011 Apr 18. </ref>
**Elevation of BNP (>90)
**ECG findings of right heart strain (see diagnosis below)
*Myocardial necrosis: Troponin I >0.4

====Non-Massive: Low-risk====
No hemodynamic compromise and no RV strain

====Sub-Segmental====
*Limited to the subsegmental pulmonary arteries