Guidelines for primary treatment and secondary antithrombosis prevention of pulmonary embolism

Abstract

Acute pulmonary embolism leads to sudden increase of pressure in pulmonary arteries and overload of the right ventricle. The management of pulmonary embolism depends on hemodynamic deterioration and consequent risk of death. All patients should be anticoagulated, however, subjects with hypotonia, in shock demand immediate resolving of thromboembolic obstruction of pulmonary arteries with thrombolysis or surgery/percutaneous embolectomy. The duration of secondary prophylaxis is a second important problem. The assessment of the risk of recurrent embolism is crucial and currently is based on primary reason of thromboembolic disease and on concentration of D-dimer one month after cease of anticoagulation.