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Pulmonary Embolism

Pulmonary · ~9% of blueprint
Pathophysiology
Venous thromboembolus (usually from a DVT) lodges in the pulmonary arteries → V/Q mismatch.
Signs & Symptoms
Sudden dyspnea, pleuritic chest pain, tachycardia, hypoxia; ± hemoptysis or calf swelling.
Gold Standard Diagnosis
CT pulmonary angiography; D-dimer to rule out when pretest probability is low (Wells score).
First-line Treatment
Anticoagulation (DOAC or heparin → warfarin); thrombolysis if massive / hemodynamically unstable.
Drug cardsApixabanHeparin (Unfractionated)EnoxaparinWarfarinAlteplase (tPA)
High-Yield Pearl

Risk-stratify with Wells or revised Geneva → D-dimer if low/intermediate, else CTPA; ESC questions PERC generalizability.

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Sources

Reviewed September 2026
  1. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism — European Society of Cardiology / European Respiratory Society, 2019
  2. American Society of Hematology 2018 Guidelines for Management of Venous Thromboembolism: Diagnosis of Venous Thromboembolism — American Society of Hematology, 2018
  3. American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism — American Society of Hematology, 2020
  4. StatPearls: Acute Pulmonary Embolism — NCBI Bookshelf, 2026

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