Patients with pulmonary emboli present both diagnostic and therapeutic challenges to the emergency clinician, because initial symptoms can be variable and overlap with other medical conditions.
Our recent issue Evidence-Based Management of Pulmonary Embolism in the Emergency Department reviews treatment options for patients with pulmonary emboli based on risk stratification scores of low, intermediate-low, intermediate-high, and high risk classifications.
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Here are a few key points:
- Even with appropriate care, approximately 15%- 30% of patients with pulmonary embolism (PE) will die within 90 days,1-3 potentially from the underlying medical pathology that led to the clot.
- Chest pain, dyspnea, and hemoptysis are common signs of PE; establishing the time of onset of symptoms can help determine the cause.
- Isolated syncope with no other symptoms suggestive for PE is not an indication for an evaluation for thromboembolic disease.
- Other findings in PE include tachypnea, tachycardia, cyanosis, lower extremity edema, and deep vein thrombosis.