Update on Pulmonary Embolism: Guideline-Based Diagnosis and Therapy of an Exemplary Case

Abstract

Update on Pulmonary Embolism: Guideline-Based Diagnosis and Therapy of an Exemplary Case Abstract. In the evaluation of acute pulmonary embolism, a swift and focused diagnostic process is crucial and has an impact on prognosis. An initial clinical assessment is done in haemodynamically stable patients, followed by determination of D-dimer or immediate imaging by computer tomography if the clinical (pre-test) probability is high. After confirming the diagnosis of pulmonary embolism, the most appropriate anticoagulant regiment should be selected and patients should be candidate for a structured follow-up plan. The initial anticoagulant therapy regime is determined by a number of factors, including haemodynamic stability (or potential need for reperfusion treatments), demographic characteristics and comorbidities. While anticoagulation is usually recommended for the first 3-6 months, re-evaluation of therapy after acute therapy is mandatory. In addition, the possibility of chronic thrombo-embolic pulmonary hypertension (CTEPH) or a post-PE syndrome should be considered if symptoms persist after 3-6 months.