Pulmonary Thromboembolism

Pulmonary thromboembolism is a serious cardiovascular and respiratory emergency caused by the obstruction of pulmonary arteries due to thrombi, most commonly originating from deep veins of the lower extremities. This condition impairs blood flow in the lungs, leading to ventilation-perfusion mismatch, hypoxemia, and in severe cases, right ventricular strain or sudden circulatory collapse. Clinical manifestations vary from mild shortness of breath and chest pain to hemoptysis, syncope, or acute hemodynamic instability, depending on clot burden and patient comorbidities. Diagnosis requires a high index of suspicion and is typically confirmed through imaging modalities such as CT pulmonary angiography, ventilation-perfusion scanning, or Doppler studies of the legs. Laboratory tests, including D-dimer assays, are often used for risk stratification. Management of pulmonary thromboembolism involves rapid initiation of anticoagulation to prevent clot extension and recurrence, with thrombolysis or surgical embolectomy considered in life-threatening cases. Catheter-directed therapies have emerged as less invasive options for select patients, offering targeted clot resolution with fewer systemic complications. Long-term care emphasizes continued anticoagulation, monitoring for chronic thromboembolic pulmonary hypertension, and addressing modifiable risk factors such as immobility, obesity, and malignancy. Preventive strategies, including early mobilization after surgery, compression devices, and prophylactic anticoagulation in high-risk individuals, are vital to reducing disease burden. Advances in diagnostic tools and personalized therapy are improving survival and minimizing long-term complications, positioning pulmonary thromboembolism management as a multidisciplinary priority in both acute and preventive care.