Post-Pulmonary Embolism Syndrome-A Diagnostic Dilemma and Challenging Management

Historically, research on pulmonary embolism (PE) management has focused on short-term outcomes, such as acute cardiovascular collapse, change in right ventricular function, and in-hospital mortality. However, long-standing functional impairments from acute PE occur in up to half of all patients. This chronic syndrome has been termed the post-PE syndrome, which describes patients who have persistent or worsening symptoms, functional limitations, and cardiorespiratory impairment not explained by a comorbid condition. Diagnosis and management are challenging, and post-PE syndrome remains an underrecognized and undertreated condition. This review seeks to increase awareness of the syndrome that affects a significant portion of PE survivors. The epidemiology, pathophysiology, and clinical features are discussed, followed by a description of imaging findings and management options across the entire spectrum of post-PE syndrome.