Pulmonary embolism (PE)

Diagnostic and therapeutic approach

  1. Diagnosis
  2. Scores
  3. Treatment
  4. Pharmaceuticals
  5. ESC recommandations

Diagnosis

Probability of pulmonary embolism

If high probability do CT scan.

Low or intermediate probability dose D-dimers. If D-dimers normal no treatment if D-dimers augmented CT scan or echocardiography.

If diagnosis of pulmonary embolism confirmed or probable estimate the risk to start treatment.

  • BP > 90 mm Hg, biomarkers and echo negatives, low risk.
  • BP > 90 mm Hg, biomarkers high (BNP, troponine) and positive echocardiography, intermediate risk.
  • BP < 90 mm Hg, shock, resuscitation high risk.

Clinical signs

  • Tachycardia. Sometimes AF.
  • Hypoxemia
  • Negative T waves from V1 to V3
  • S1, Q3 and T3 waves.