Acute pulmonary embolism

Clin Med (Lond). 2019 May;19(3):243-247. doi: 10.7861/clinmedicine.19-3-247.


Pulmonary embolism, despite being common, often remains elusive as a diagnosis, and clinical suspicion needs to remain high when seeing a patient with cardiopulmonary symptoms. Once suspected, diagnosis is usually straightforward; however, optimal treatment can be difficult. Risk stratification with clinical scores, biomarkers and imaging helps to refine the best treatment strategy, but the position of thrombolysis in intermediate risk (submassive) pulmonary embolism remains a grey area. Pulmonary embolism response teams are on the increase to provide advice in such cases. Direct oral anticoagulants have been a major advance in treatment this decade, but are not appropriate for all patients. Follow-up of patients with pulmonary embolism should be mandatory to determine duration of anticoagulation and to assess for serious long-term complications.

Keywords: Pulmonary embolism; thrombolysis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anticoagulants / therapeutic use
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / therapy
  • Thrombolytic Therapy


  • Anticoagulants
  • Fibrinolytic Agents