[Acute pulmonary embolism]

Pulmonary embolism is a frequent event, even today the diagnostic comes often too late or not at all. Symptoms, clinical results and additional examinations like ECG, echocardiography, scintigraphy and angiography permit the differentiation between small peripheral and massive central pulmonary embolism [PE], important for the therapeutic procedure. Patients with peripheral PE have to be heparinized, sometimes they can be treated at home. The acute massive PE represents an emergency situation, the patient must be hospitalized immediately. The goals of therapy in massive PE consist in a rapid reduction of the threatening load on the right ventricule by the embolism. If the patient is in cardiogenic shock, surgical embolectomy is indicated, without shock the immediate start of thrombolytic therapy must be considered.