Pulmonary embolism. Diagnosis and treatment

Abstract

The lecture is based on 2014 ESC Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism (APE) 2014. It tells about the prevalence, risk factors and etiology of APE. The pathophysiological mechanisms of the development of respiratory and cardiac failure in APE are considered. The criteria for assessing clinical probability, sensitivity and specificity of laboratory and instrumental methods, algorithms for the diagnosis of APE and methods of risk stratification for early death of patients are discussed. While considering the current guidelines for APE pharmacotherapy, the authors focus on the use of new oral anticoagulants. In particular, they emphasize that in the acute phase of the disease, rivaroxaban and apixaban may be used as an alternative to the combination of heparin with warfarin. Indications, contraindications and regimens of thrombolytic therapy, and indications for surgical embolectomy and cava filter implantation are presented.