Acute pulmonary embolism (APE) is one of the diseases posing immense death rates and a great burden to public health. APE defines a blood clot or other substance in the deep leg/calf vein that traverses through the right heart and blocks the pulmonary arterial bloodflow (venous thromboembolism, VTE). The severity of the signs and symptoms of APE depends on the size of the thrombus and location of the occlusion, together with the previous reserves of the individual. A presentation template that will fit all cases cannot be put forward. “Massive” or hemodynamically unstable PE has a high death rate despite contemporary management. Healthcare personnel should be alerted to recognize untreated patient with high probability for APE in the ED and primary care institutions. Treatment should be expedient and aggressive in accord with the patient’s instability. Systemic or catheter-mediated thrombolysis, anticoagulation and other approaches should be contemplated immediately after general supportive measures.
This chapter delineates diagnostic dilemmas, distinctive properties and management principles of APE in the emergency setting. Also, challenges brought into scene with COVID-19 pandemics is discussed.