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.
Keywords: Acute pulmonary embolism, Thromboembolism.