Acute pulmonary embolism.

Copyright © 2010 Massachusetts Medical Society. The clinical presentation of acute pulmonary embolism ranges from shock or sustained hypotension to mild dyspnea. Pulmonary embolism may even be asymptomatic and diagnosed by imaging procedures performed for other purposes. Depending on the clinical presentation, the case fatality rate for acute pulmonary embolism ranges from about 60% to less than 1%.1 Anticoagulation is the foundation of therapy for pulmonary embolism. Depending on the estimated risk of an adverse outcome, admission to an intensive care unit and treatment with thrombolysis or catheter or surgical embolectomy may be required, but early hospital discharge or even home treatment may be considered. This review focuses on the optimal diagnostic strategy and management, according to the clinical presentation and estimated risk of an adverse outcome.