[Acute lung embolism: pathophysiology, clinical aspects and therapy]

Area of Science:

• Cardiology
• Pulmonary Medicine
• Vascular Surgery

Background:

• Pulmonary embolism (PE) diagnosis is missed in 60-70% of cases, resulting in poor patient outcomes.
• Relapsing embolism is a significant factor contributing to the poor prognosis in undiagnosed PE.
• Understanding the pathophysiological contexts of PE is crucial for accurate clinical diagnosis and severity assessment.

Purpose of the Study:

• To highlight the diagnostic challenges and poor outcomes associated with missed pulmonary embolism.
• To emphasize the importance of pathophysiological knowledge for clinical diagnosis and embolism grading.
• To outline current treatment strategies for pulmonary embolism, including conservative and surgical options.

Main Methods:

• Review of existing literature and clinical data on pulmonary embolism diagnosis and management.
• Analysis of factors contributing to missed diagnoses and poor outcomes.
• Evaluation of the efficacy of conservative treatment versus emergency embolectomy for severe central PE.

Main Results:

• A significant proportion of pulmonary embolism cases (60-70%) are initially misdiagnosed.
• Conservative treatment is effective for most pulmonary embolism cases.
• Emergency embolectomy is indicated for severe central pulmonary embolism, with reduced mortality due to cardiopulmonary bypass.

Conclusions:

• Improved diagnostic awareness and understanding of PE pathophysiology are essential.
• Timely and appropriate treatment, including consideration of emergency embolectomy for severe cases, can improve patient outcomes.
• Advances in surgical techniques, such as cardiopulmonary bypass, have significantly improved the safety of embolectomy procedures.