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Review
. 2023 Sep-Oct;75(5):335-342.
doi: 10.1016/j.ihj.2023.05.007. Epub 2023 May 17.

Acute pulmonary embolism: Diagnosis and management

Harshwardhan Khandait  1 , Pankaj Harkut  2 , Vinod Khandait  3 , Vijay Bang  4
Affiliations
Review

Acute pulmonary embolism: Diagnosis and management

Harshwardhan Khandait et al. Indian Heart J. 2023 Sep-Oct.

Abstract

Acute pulmonary embolism (PE) can present with non-specific signs and symptoms and thus the diagnosis and management might not be as straightforward. This review outlines the new PE management guidelines in the Indian context. The exact prevalence in the Indian population is not well defined; despite recent studies suggesting an increasing trend in the Asian population. A delay in treatment can be fatal, especially in massive PE. The nuances associated with stratification and management have led to heterogeneity in acute PE management. The purpose of the review is. 1: To highlight the principles of stratification, diagnosis and management of acute PE with a special attention towards the Indian population. 2: To aid patient selection for newer catheter based therapies. To conclude, formulation of pulmonary embolism guidelines in the Indian setting is required underlying the role of further research in this area.

Keywords: Anticoagulation; Embolism; Pulmonary; Thrombolysis.

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Conflict of interest statement

Declaration of competing interest None.

Figures

Fig. 1
Fig. 1
Overview of pulmonary embolism stratification, diagnosis and management., CTPA: Computed tomography pulmonary angiography, V/Q: Ventilation perfusion scan, US: Ultrasound, PESI: Pulmonary embolism severity index, sPESI: Simplified pulmonary embolism severity index, IVC: Inferior vena cava, VTE: Venous thromboembolism, CTEPH: chronic thromboembolism pulmonary hypertension.
Fig. 2
Fig. 2
Use of Doppler ultrasound to evaluate suspected acute PE.
Fig. 3
Fig. 3
Approach to risk stratification.
Fig. 4
Fig. 4
Approach to management.
Fig. 5
Fig. 5
Management of high risk PE, CBT = catheter based thrombectomy, MCS = mechanical circulatory support, RHC = right heart catheterisation.
Fig. 6
Fig. 6
Management of intermediate high risk PE, CBT = catheter based thrombectomy, MCS = mechanical circulatory support + indicates success and - indicates failure.
See this image and copyright information in PMC

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