[Clinical aspects, diagnosis and therapy of pulmonary embolism]

Abstract

Pulmonary embolism is a frequent and malignant complication of other diseases. To consider this is the most important step. ECG, pO2/pCO2, chest X-ray are used for differential diagnosis; pulmonary embolism is directly confirmed by scintigraphy, echocardiography, pulmonary angiography and pulmonary artery catheterisation, supplemented by examination of lower venous system (sonography, phlebography). Small emboli should also be noted as a signal of dangerous recurrence. The choice of the therapeutic method (embolectomy, fibrinolysis, anticoagulation) depends on the severity of pulmonary embolism, available methods and present contraindications. Depending upon the severity and general condition of the patient, it may be necessary to disregard possible contraindications against therapeutic methods that may cause desobliteration. Anticoagulation is used as prophylactic method, in exceptional cases a blockade is applied to the vena cava inferior.