Embolismo pulmonar agudo: revisión actualizada del abordaje diagnóstico y terapéutico

Abstract

Acute pulmonary embolism (PE) is defined as an occlusion of the pulmonary circulation that impairs distal blood flow, usually secondary to thrombosis originating in the proximal deep venous circulation of the lower limbs. It has an annual incidence of 1 case per 1000 persons, with an approximate mortality of 20%, and is the third most frequent cardiovascular disorder. The main risk factors are associated with blood stasis, hypercoagulable states and endothelial injury, and these are frequently manifested in patients hospitalized for surgery or hospital admissions for medical illness. Their morbidity and mortality is mainly conditioned by cardiovascular involvement, characterized by right ventricular pressure and volume overload, and eventually obstructive shock. The clinical presentation is usually nonspecific, and therefore requires the use of clinical predictive tools and imaging techniques that are becoming increasingly available and specific. Once the diagnosis has been made or if there is a high clinical suspicion, treatment is initiated according to individual risk stratification. This literature review summarizes updates on the diagnostic and therapeutic approach to acute PE in adults.