[What etiologic investigations should be done following recurrent pulmonary embolism?]

Recurrence of pulmonary embolism can occur in presence of coagulation disorders or cancer. It can also develop without any of these factors. Coagulation tests should search for abnormalities such as inherited deficiencies of antithrombin, protein C, protein S, factor V mutation, variation of the prothrombin gene, hyperhomocysteinaemia, lupus anticoagulant, antiphospholipid antibodies. Biological examinations for determining the cause of recurrent pulmonary should be associated with a familial enquiry. An aggressive search for an occult cancer in a patient with a recurrent pulmonary embolism is not warranted. An evaluation includes medical history, physical examination, laboratory tests, chest X-ray sufficient to orientate this investigation. Patients should be given long-course oral anticoagulant treatment. However, the optimal duration have still to be determined.