Skip to main content

Pulmonary Embolism

Reviewed 06/2020
 


BASICS

Pulmonary embolism (PE) is an acute cardiovascular disorder that requires emergent medical attention due to its high early mortality rates. PE causes pulmonary vascular bed obstruction, which r...

DIAGNOSIS

  • Establish a pretest probability based on clinical criteria.

    • Wells score

      • Clinical signs and symptoms of DVT +3

      • Alternative diagnosis is less likely than PE +3.

      • Heart rate >100 +1.5

      • Immobilizati...

TREATMENT

Treatment is based on risk stratification. 
  • Low-risk PE – use anticoagulation or IVC filter.

  • Submassive PE – anticoagulation + possible INR guided thrombolysis

  • Massive PE – anticoagulation + de...

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...

REFERENCES

1
Lee LH, Gallus A, Jindal R, et al. Incidence of venous thromboembolism in Asian populations: a systematic review. Thromb Haemost.  2017;117(12):2243–2260.

CODES

ICD10

  • I26.99 Other pulmonary embolism without acute cor pulmonale

  • I27.82 Chronic pulmonary embolism

ICD9

  • 415.19 Other pulmonary embolism and infarction

  • 416.2 Chronic pulmonary embolism

SNOMED

  • 59282003 ...

CLINICAL PEARLS

  • Use Wells criteria; obtain D-dimer for low and intermediate risk; spiral CT angiography for high risk.

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×