title: Pulmonary embolism.
abstract: PE is one of the great challenges in medicine. It is a disease that carries with it a high mortality rate, yet no historical piece of information, physical examination finding, or diagnostic modality is perfect at excluding its possibility. Emergency physicians must be vigilant about considering PE in the differential diagnosis of a variety of presenting complaints and must use a variety of diagnostic and therapeutic options as they manage patients with suspected or confirmed PE. The diagnostic options range from bedside diagnostic tests to highly specialized imaging available at only specialized institutions. Knowing the advantages and disadvantages of each of the diagnostic modalities assists the physician in employing the best test. Therapeutic options also vary widely and include anticoagulation, vena caval interruption, systemic thrombolysis, embolectomy, and other therapeutic adjuncts, such as ECMO and inhaled nitric oxide. Similarly, awareness of the indications and contraindications to the varied therapeutic agents ensures appropriate therapy when the diagnosis is made.
authors.affiliation: Department of Emergency Medicine, Mayo Medical School, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. sadosty.annie@mayo.edu
authors.forename: Annie T
authors.initials: AT
authors.lastname: Sadosty
authors.forename: Eric T
authors.initials: ET
authors.lastname: Boie
authors.forename: Latha G
authors.initials: LG
authors.lastname: Stead
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D000933:Antifibrinolytic Agents; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D003935:Diagnostic Techniques, Cardiovascular; D003948:Diagnostic Techniques, Respiratory System; D017128:Embolectomy / Q000379:methods; D005338:Fibrin Fibrinogen Degradation Products; D006801:Humans; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012126:Respiratory Dead Space; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000379:methods; D016306:Vena Cava Filters
chemical_list: D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D