Key messages

• Pulmonary embolism accounts for up to 150 000 deaths annually in the United States.

• Mortality is approximately 10 per cent in patients properly diagnosed and treated.

• Presenting features include dyspnea, chest pain, cough, and hemoptysis; with major emboli, there is cardiovascular collapse.

• Diagnostic modalities include 12-lead electrocardiography, chest radiography, arterial blood gas analysis, ventilation-perfusion scanning, CT, and, for definitive diagnosis, pulmonary angiography.

• Classification in terms of severity is useful for determining treatment strategies and prognostication.

• Treatment is supportive, with oxygen, fluid loading, and inotropes if necessary. Judicious use of heparinization, thrombolysis, and embolectomy, depending on disease severity, has been shown to reduce mortality and morbidity significantly.

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