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.

High-Yield Pearl

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

Sources

Reviewed September 2026

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