Pulmonary embolism: Care standards in 2018

Prog Cardiovasc Dis. Mar-Apr 2018;60(6):613-621. doi: 10.1016/j.pcad.2017.12.005. Epub 2017 Dec 29.

Abstract

Pulmonary embolism (PE) is a leading cause of cardiovascular mortality worldwide. Clinical presentation can be diverse, and clinicians should have a high index of suspicion regarding the diagnosis. Evaluation should include detailed history of possible risk factors, physical examination and laboratory tests that would support the diagnosis and help risk-stratify patients. Finally, a dedicated imaging study should be performed in order to make a definitive diagnosis. Decisions regarding short-term, immediate, treatment are dictated by PE risk category. Treatment of low and high-risk PE is relatively straightforward. But treating moderate risk PE is challenging since aggressive treatment is not devoid of potential harm. This review focuses on the acute and chronic treatment of PE. We present risk stratification, guidance as to treatment choice and insights into chronic treatment with available anticoagulants.

Keywords: Deep venous thrombosis; Pulmonary embolism; Venous thromboembolism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Aged
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Biomarkers / blood
  • Chronic Disease
  • Computed Tomography Angiography / methods
  • Disease Management
  • Humans
  • Male
  • Natriuretic Peptide, Brain / blood
  • Practice Guidelines as Topic / standards*
  • Prognosis
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / drug therapy*
  • Pulmonary Embolism / mortality
  • Risk Assessment
  • Severity of Illness Index
  • Standard of Care
  • Survival Rate
  • Treatment Outcome
  • Troponin / blood

Substances

  • Anticoagulants
  • Biomarkers
  • Troponin
  • Natriuretic Peptide, Brain