AbstractPulmonary embolism (PE) is a common and lethal condition causing mostly from thrombi in iliac and femeral veines. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. Despite diagnostic advances, delays in pulmonary embolism diagnosis are common and represent an important issue (1) As a cause of sudden death, massive pulmonary embolism is second only to sudden cardiac death in US. In patients who survive a pulmonary embolism, recurrent embolism and death can be prevented with prompt diagnosis and therapy. Unfortunately, the diagnosis is often missed because patients with pulmonary embolism present with nonspecific signs and symptoms. If left untreated, approximately one third of patients who survive an initial pulmonary embolism die from a subsequent embolic episode. After 2 years suffered from PE, 3.8% of the patients develop chronic thromboembolic pulmonary arterial hypertension (CTEPH) (2).
Ozsu S, Oztuna F, Bulbul Y, et al. (2011, Jan 29). The role of risk factors in delayed diagnosis of pulmonary embolism. Am J Emerg Med. (1): 26-32.
Pengo V. (2004). NEJM.
Tapson VF and Humbert M. (2006). Proct Am Thoract Soc. 3, 564-567
Tapson VF. (2012). F 1000 Medicine Reports. 4:9 (doi:10:3410/4-9)
Go AS et al. Circulation. (2014). 129:e28-e292
Kline JA, Runyon MS. (n.d.). Pulmonary embolism and deep venous thrombosis. In: Marx JA, Hockenberger RS, Walls RM, eds. Rosen's Emergency Medicine Concepts and Clinical Practice. 6th ed. 1368-1382. Vol 2.
Worsley DF, Alavi A. (1995). Comprehensive analysis of the results of the PIOPED Study, Prospective Investigation of Pulmonary Embolism Diagnosis Study. J Nucl Med. 36(12):2380-7
Boyden EA. (1955). Segmental Anatomy of the Lungs: Study of the Patterns of the Segmental Bronchi and Related Pulmonary Vessels. New York, NY: McGraw-Hill. 23-32.
Sandler DA, Martin JF. (1989, April). Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis?. J R Soc Med. 82(4):203-5.
Goldhaber SZ, Visani L, De Rosa M. (1999, April 24). Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 353(9162):1386-9
Wood KE. (2002 March). Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest. 121(3):877-905
Kucher N, Rossi E, De Rosa M, Goldhaber SZ. (2006, Jan 31). Massive pulmonary embolism. Circulation. 113(4):577-82
Meyer G, Planquette B, Sanchez O. (2008, Sep). Long-term outcome of pulmonary embolism. Curr Opin Hematol. 15(5):499-503