Pulmonary embolism
FAST Score
Three-item score for haemodynamically stable PE (Dellas 2014): heart-type fatty acid–binding protein ≥ 6 ng/mL (1.5), syncope (1.5) and heart rate ≥ 100 bpm (2). A score ≥ 3 identifies patients at higher risk of PE-related death, haemodynamic collapse or rescue reperfusion, similar to Bova stage III. Where H-FABP is not available, hs-troponin T ≥ 14 pg/mL can replace it (modified FAST, Hobohm 2016).
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Myocardial injury marker
Additional criteria
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Total score
0
FAST < 3: lower risk
Complicated 30-day course rare (negative predictive value ≈ 98–99%)
Decision guide
Normotensive PE with a favourable course expected. Anticoagulate; combine with sPESI/Hestia and RV imaging to decide on early discharge or ward care.
1 section is still unanswered — counted as 0 points.
Ranges: 0–2.5 FAST < 3: lower risk3–5 FAST ≥ 3: higher risk
References
- Dellas C, et al. A novel H-FABP assay and a fast prognostic score for risk assessment of normotensive pulmonary embolism. Thromb Haemost 2014;112:996-1003.
- Hobohm L, et al. Comparison of risk assessment strategies for not-high-risk pulmonary embolism. Eur Respir J 2016;47:1170-1178.
- Konstantinides SV, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism. Eur Heart J 2020;41:543-603.
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