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Pulmonary Embolism

Maria Lynn Rossi, MD, MS, Waiz Wasey, MD, FAAFP and Roxanne JL Bautista, MD Reviewed 05/2023
 


BASICS

Pulmonary embolism (PE) is an acute cardiovascular disorder that causes pulmonary vascular bed obstruction, resulting in acute right ventricular failure 

DESCRIPTION

  • PE is the most serious presen...

DIAGNOSIS

  • Establish a pretest probability based on clinical criteria.

    • Wells Score (each predictor is +1; PE unlikely if 0 to 1, PE likely if >2)

    • Geneva scores (Each predictor is +1 except for heart r...

TREATMENT

Patients with acute PE should be treated for at least 3-6 months. 
Treatment is based on risk stratification (2). 
  • Low risk PE → use anticoagulation or inferior vena cava (IVC) filter. Assess...

ONGOING CARE

Duration of anticoagulation 
  • Provoked PE (trigger no longer present): 3 months

  • Unprovoked PE: >3 months; consider long-term or prolonged secondary prophylaxis if bleeding risk is low. HE...

REFERENCE

1
Lee LH, Gallus A, Jindal R, et al. Incidence of venous thromboembolism in Asian populations:a systemic review. Thromb Haemost. 2017;117(12):2243–2260.
2
Kahn SR, de Wit K. Pulmonary Embolism....

CODES

ICD10

  • I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale

  • I26.92 Saddle embolus of pulmonary artery without acute cor pulmonale

  • I26.01 Septic pulmonary embolism with acute cor pulmon...

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