Early recognition of pulmonary embolism: the key to lowering mortality

Pulmonary embolism is a major cause of morbidity and mortality in the United States. The majority of deaths from pulmonary embolism occur because an accurate diagnosis was not made. It is imperative for clinicians to have a high level of clinical suspicion of pulmonary embolism when patients present with dyspnea, tachypnea, chest pain, hemoptysis, and cough. If pulmonary embolism is diagnosed and treatment initiated, death and recurrence of embolism are uncommon. Beyond correct diagnosis and treatment, the single most effective strategy that can be employed to decrease the high mortality associated with pulmonary embolism is identification of individuals at risk and the institution of prophylactic measures. This article reviews the incidence, risk factors, assessment, physical examination, laboratory, and diagnostic testing for pulmonary embolism.