Summary

• PE is a life-threatening condition resulting from dislodged thrombi occluding the pulmonary vasculature; right heart failure and cardiac arrest may ensue if not aggressively treated.
• Virchow's triad of venous stasis, vessel wall damage, and hypercoagulability reflect the underlying pathophysiology.
• Symptoms include chest pain (88%), dyspnoea (84%), and a sense of apprehension (59%). Syncope occurs in 13% of cases, and is strongly associated with increased clot burden.
• Signs include tachypnoea (respiratory rate >16 breaths per minute) (92%), fever >37.8°C (100.0°F) (43%), and heart rate >100 bpm (44%).
• Definitive diagnostic modalities of exclusion/confirmation include D-dimer, multiple-detectors computed tomographic pulmonary angiography (CTPA) of chest, ventilation perfusion (V/Q) scan, and pulmonary angiography.
• Acute treatment includes thrombolysis, surgical embolectomy, inferior vena cava (IVC) filter placement, and heparin administration; warfarin is the long-term anticoagulant of choice.