Acute Pulmonary Embolism

Excerpt

Acute pulmonary embolism (PE) is a life-threatening condition that occurs when a blood clot that has arisen from a different area obstructs the pulmonary arteries. Most commonly, PE originates from a deep vein thrombosis (DVT) in the lower extremities. PE usually occurs when a part of this thrombus breaks off and enters the pulmonary circulation. PE rarely occurs from embolizing other materials into the pulmonary circulation, eg, air, fat, or tumor cells. Together, PE and DVT comprise venous thromboembolism (VTE), a significant cause of morbidity and mortality worldwide. Risk factors for PE include genetic predispositions like thrombophilia and acquired conditions, including prolonged immobility, surgery, and malignancy.

Despite advancements in diagnostic tools and treatment options, the nonspecific symptoms of PE (eg, dyspnea, chest pain, and syncope) often overlap with other cardiovascular and respiratory conditions, making timely diagnosis challenging for clinicians. Prompt recognition and management of PE are critical, as delayed intervention can lead to severe complications, including hemodynamic instability, right ventricular failure, and sudden death. Risk stratification tools such as the Wells criteria and Geneva score, alongside diagnostic imaging, are essential for accurate diagnosis. However, the underutilization of these tools, coupled with variations in therapeutic approaches, underscores the need for standardized clinical protocols. Clinicians can improve patient outcomes through enhanced knowledge and proficiency in identifying risk factors, employing diagnostic strategies, and initiating evidence-based treatments.