Acute Pulmonary Embolism: Definition, Epidemiology, Pathophysiology, and Risk Factors

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Acute Pulmonary Embolism A Review Yonathan Freund, MD, PhD; Fleur Cohen-Aubart, MD, PhD; Ben Bloom, MD, PhD P ulmonary embolism (PE) is defined as occlusion in the pulmonary arterial tree, preventing blood flow distal to the occlusion. PE is most frequently caused by thrombosis in a systemic blood vessel, usually in a deep vein of the lower limb. In western countries, the incidence of PE in the general population is approximately 60 to 120 cases per 100 000 population per year, with an in-hospital mortality of 14% and a 90-day mortality of 20%. 1-3 It is estimated that approximately 60 to 100 000 patients die of PE each year in the US. 3,4 Because symptoms are nonspecific, PE remains a diagnostic challenge, and fewer than 10% of patients evaluated for PE are ultimately diagnosed with a PE. 5-8 This review summarizes current evidence regarding the diagnosis and treatment of acute pulmonary thromboembo- lism in adults. Methods We searched PubMed for English-language studies published between January 1, 2010, and March 1, 2022, that examined the epidemiology, diagnosis, and treatment of pulmonary embolism. Articles were screened using the MeSH term pulmonary embolism associated with d...