Each year in the United States, it is estimated that between 600,000 and 900,000 individuals suffer from acute pulmonary embolism (PE), accounting for an estimated 200,000 to 300,000 hospital admissions.1-4 In the United States, as many as 100,000 deaths are estimated to be caused by venous thromboembolism each year. Furthermore, numerous studies have found that approximately 1% of all patients admitted to hospitals die of acute PE, and an estimated 10% of all hospital deaths are PE related.5-7 If left untreated, PE can be rapidly fatal.2,8,9
Improvements in detection and treatment of deep vein thromboses, venous thromboembolism prophylaxis protocols, and improvements in the sensitivity and specificity of diagnostic tests have resulted in a substantially decreased overall mortality from PE in the past decade.3,10 Nonetheless, despite these advancements, PE still remains a fatal pathology, with a mortality rate of up to 10% of all patients diagnosed with an acute PE in the first 1 to 3 months following diagnosis.11,12 While the mortality of PE is well publicized, the morbidity associated with undiagnosed PE is not, and it can be very disabling, leading to both pulmonary hypertension and postthrombotic syndrome.4,13-15 This issue of Emergency Medicine Practice presents a review of the current evidence guiding the emergency medicine approach to the diagnosis and treatment of PE.
Amy Church; Matthew Tichauer
December 2, 2012