title: [Pulmonary thromboembolism].
abstract: Pulmonary thromboembolism is a frequent disease in emergency departments and often poses a diagnostic challenge that requires appropriate strategies. Clinical information, laboratory tests such as a D-dimer and imaging techniques such as computed tomography (CT) angiography, ventilation-perfusion scintigraphy or echocardiography help to establish clinical probability and the severity of the disease. With all this information, risk scores can be constructed, such as the Pulmonary Embolism Severity Index (PESI) score, which has high sensitivity in predicting mortality. Treatment should be started immediately with heparin, usually low molecular weight heparin. If the patient is at high risk, thrombolytic therapy is indicated, although possible contraindications should be thoroughly assessed. Supportive treatment may be considered in a few patients.
authors.affiliation: Servicio de Neumología, Complejo Hospitalario de Pontevedra, Pontevedra, España. adolfo.baloira.villar@sergas.es
authors.forename: Adolfo
authors.initials: A
authors.lastname: Baloira Villar
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Ruiz Iturriaga
mesh_terms: D000328:Adult; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D015415:Biomarkers; D000075202:Contraindications; D003952:Diagnostic Imaging; D017128:Embolectomy / Q000379:methods; D004630:Emergencies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery; D012307:Risk Factors; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy / Q000379:methods
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D; D006493:Heparin