Abstract
Pulmonary embolism (PE) is currently the third leading cause of death and moreover
is likely underdiagnosed. PE remains the most common preventable cause of hospital
deaths in the United States, which may be attributable to its diagnostic challenges.
Although difficult to diagnose, patient mortality rates are time-dependent, and thus,
the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based
on several criteria which may dictate imaging workup as well as laboratory tests and
clinical parameters are discussed. The evolution of treatment guidelines via various
clinical trials and recommendations is outlined, setting the stage for the use of
fibrinolytics, whether systemic or catheter directed. Treatment, including fibrinolytics,
is predicated on patient triage into three large categories—massive, submassive, or
low-risk PE. Additionally, a relatively new concept of a multidisciplinary team composed
of several subspecialty experts known as the PE response team (PERT) is discussed.
PERT's timely and unified recommendations have been shown to optimize care and decrease
mortality while tailoring treatment to each individual afflicted by PE.
Keywords
pulmonary embolism - catheter-directed therapy - massive pulmonary embolism - submassive
pulmonary embolism - pulmonary embolism response team - interventional radiology
