[Diagnosis and therapy of pulmonary embolism]

Pulmonary embolism (PE) as a potentially life-threatening condition requires immediate medical intervention. Even the mere suspicion of a PE demands the initiation of a therapy with heparin. According to the patient's hemodynamic stability further diagnostic and therapeutic steps have to be taken. In case of a stable hemodynamic situation both the clinical probability of a PE and diagnostic imaging as well as the determination of D-dimers lead to the diagnosis. These patients should be anticoagulated with heparin. Unstable hemodynamic patients need to be monitored on the intensive care unit; echocardiography and, if needed, spiral computed tomography are the most important diagnostic tools. Due to this serious situation lung artery perfusion needs to be restituted by thrombolysis. Additionally, secondary prevention with vitamin K antagonists (INR [International Normalized Ratio] 2.0-3.0) is recommended depending on anamnesis and accordance to a risk group.