Related Experiment Video
Updated: Dec 19, 2025
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
[Update diagnosis and therapeutic management of pulmonary embolism]
Matthias Ebner1, Mareike Lankeit2
1Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Campus Charité-Mitte (CCM), Charité-Universitätsmedizin Berlin.
Insights
Pulmonary embolism (PE) management is updated with new European Society of Cardiology guidelines. These emphasize standardized diagnosis, risk stratification, and novel oral anticoagulants (NOACs) for effective PE treatment.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Vascular Medicine
Background:
- Pulmonary embolism (PE) is a leading cardiovascular cause of death with increasing incidence.
- Recent European Society of Cardiology (ESC) guidelines offer updated diagnostic and therapeutic strategies for PE.
- Accurate risk stratification and timely treatment are crucial for improving patient outcomes.
Purpose of the Study:
- To summarize the key updates and recommendations from the 2019 ESC guidelines for diagnosing and managing pulmonary embolism.
- To highlight the integration of new findings into clinical practice for PE patients.
- To provide an overview of current best practices in PE management.
Main Methods:
- Review of the 2019 European Society of Cardiology (ESC) guidelines on diagnosis and management of PE.
- Analysis of updated diagnostic algorithms including clinical probability, D-dimer, compression sonography, and CTPA.
- Evaluation of risk stratification methods incorporating right ventricular function assessment.
- Assessment of therapeutic recommendations including anticoagulation and patient selection for home treatment.
Main Results:
- A standardized diagnostic approach is recommended for all suspected PE cases, including pregnant patients.
- Right ventricular (RV) function assessment is integral to risk stratification, with RV/LV diameter ratio measurable on CTPA.
- Low-risk patients may be candidates for home treatment.
- Interdisciplinary Pulmonary Embolism Response Teams (PERT) are advised for managing hemodynamically unstable patients.
- Novel oral anticoagulants (NOACs) are the preferred anticoagulation therapy for PE.
- A minimum anticoagulation duration of 3 months is recommended, with consideration for prolonged therapy in specific patient groups.
Conclusions:
- The 2019 ESC guidelines provide a comprehensive update for pulmonary embolism diagnosis and management.
- Emphasis is placed on standardized diagnostic pathways, risk stratification including RV assessment, and tailored therapeutic strategies.
- NOACs represent the therapy of choice for anticoagulation, with individualized duration recommendations.
Abstract:
Pulmonary embolism (PE) is a life-threatening disease and the third most frequent cardiovascular cause of death after stroke and myocardial infarction. The annual incidence is increasing. The recently published 2019 guidelines of the European Society of Cardiology integrate numerous new study findings and provide updated diagnostic and therapeutic algorithms. A standardized diagnostic approach based on clinical probability, D-dimer levels, compression sonography of the leg veins and (if necessary) CTPA should also be applied in pregnant patients with suspected PE. Assessment of right ventricular function on imaging should be part of risk stratification in every patient; the RV/LV diameter ratio can be assessed on CTPA performed for diagnosis of PE. Low risk patients are eligible for home treatment if no other reasons for hospitalization are present. Treatment decision for hemodynamically unstable patients should be made by interdisciplinary Pulmonary Embolism Response Teams. NOACs are recommended as the therapy of choice for anticoagulation of patients with PE. The duration of anticoagulation should be at least 3 months and prolonged anticoagulation should be considered for all patients without a strong triggering reversible risk factor.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:27Pulmonary Embolism III: Nursing Management
01:29Pulmonary Embolism I: Introduction
01:29Venous Thrombosis III: Interprofessional Care
01:30Venous Thrombosis IV: Nursing Management
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...