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Diagnosis and management of pulmonary embolism 

Diagnosis and management of pulmonary embolism
Chapter:
Diagnosis and management of pulmonary embolism
Author(s):

Mervyn Singer

DOI:
10.1093/med/9780199600830.003.0171
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date: 30 November 2020

Computerized tomographic pulmonary angiography is the current gold standard tool for the diagnosis of pulmonary embolism. Mortality risk stratification based on clinical, imaging, and biochemical indices dictates the treatment strategy employed in an individual patient from outpatient anticoagulation to surgical or percutaneous embolectomy for severe, life-threatening cases.Presentation of acute pulmonary embolism ranges from a chance diagnostic finding in an otherwise asymptomatic patient through to shock and cardiac arrest. The degree of obstruction and the ability (or otherwise) of the patient to compensate for any cardiorespiratory derangement will dictate the symptomatology, clinical findings, and eventual outcome. The scale of medical intervention—ranging from anticoagulation through to thrombolysis and, on occasion, embolectomy—can be based on a variety of clinical, biochemical and imaging risk indices.

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