Highlights & Basics
- Pulmonary embolism (PE) is a potentially life-threatening condition typically resulting from dislodged thrombus occluding the pulmonary arteries. Right heart failure and cardiac arrest may ensue if not aggressively treated.
- Patients who develop PE commonly have thromboembolic risk factors, such as cancer, trauma, major surgery, hospitalization, immobilization, pregnancy, or oral contraceptive use. PE may also be unprovoked (idiopathic), occurring in the absence of any identifiable extrinsic risk factors.
- Symptoms include chest pain (especially with a deep breath), dyspnea, and a sense of apprehension. Hemoptysis and syncope are less common; the latter is strongly associated with increased clot burden.
- PE is definitively confirmed by an imaging study, most commonly computed tomography pulmonary angiogram (CTPA). Diagnostic algorithms that include assessment of the likelihood of PE being present should be used to optimize the number of patients undergoing an imaging study.
- Most patients with PE are successfully treated with anticoagulant therapy. Low-risk patients may be treated without hospitalization.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Summary: pulmonary embolism diagnostic pathway
Original and simplified Wells criteria (modified)
Original and simplified Geneva score (revised)
Contrasted CTPA scan showing subsegmental right pulmonary artery emboli (see arrows)
Gd-MRA showing a right main pulmonary artery pulmonary embolism (see arrow)
PESI criteria and risk stratification
sPESI criteria and risk stratification
Citations
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