Pulmonary embolism

Nat Rev Dis Primers. 2018 May 17:4:18028. doi: 10.1038/nrdp.2018.28.

Abstract

Pulmonary embolism (PE) is caused by emboli, which have originated from venous thrombi, travelling to and occluding the arteries of the lung. PE is the most dangerous form of venous thromboembolism, and undiagnosed or untreated PE can be fatal. Acute PE is associated with right ventricular dysfunction, which can lead to arrhythmia, haemodynamic collapse and shock. Furthermore, individuals who survive PE can develop post-PE syndrome, which is characterized by chronic thrombotic remains in the pulmonary arteries, persistent right ventricular dysfunction, decreased quality of life and/or chronic functional limitations. Several important improvements have been made in the diagnostic and therapeutic management of acute PE in recent years, such as the introduction of a simplified diagnostic algorithm for suspected PE as well as phase III trials demonstrating the value of direct oral anticoagulants in acute and extended treatment of venous thromboembolism. Future research should aim to address novel treatment options (for example, fibrinolysis enhancers) and improved methods for predicting long-term complications and defining optimal anticoagulant therapy parameters in individual patients, and to gain a greater understanding of post-PE syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Decision Support Techniques
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / epidemiology
  • Pulmonary Embolism / physiopathology
  • Quality of Life / psychology
  • Risk Factors
  • Sex Factors
  • Venous Thrombosis / complications*
  • Venous Thrombosis / drug therapy
  • Ventricular Dysfunction, Right / complications

Substances

  • Anticoagulants
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D