[Pulmonary thromboembolism]

Abstract

Pulmonary thromboembolism is a frequent disease in emergency departments and often poses a diagnostic challenge that requires appropriate strategies. Clinical information, laboratory tests such as a D-dimer and imaging techniques such as computed tomography (CT) angiography, ventilation-perfusion scintigraphy or echocardiography help to establish clinical probability and the severity of the disease. With all this information, risk scores can be constructed, such as the Pulmonary Embolism Severity Index (PESI) score, which has high sensitivity in predicting mortality. Treatment should be started immediately with heparin, usually low molecular weight heparin. If the patient is at high risk, thrombolytic therapy is indicated, although possible contraindications should be thoroughly assessed. Supportive treatment may be considered in a few patients.