Pulmonary embolism pathophysiology

Pulmonary embolism pathophysiology overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]

Synonyms and keywords: PE

Pulmonary embolism (PE) is a common illness that can cause death and significant disability. PE occurs when there is an acute obstruction of the pulmonary artery (or one of its branches). Most often this is due to a venous thrombus (blood clot from a vein), which has been dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. This process is termed thromboembolism.

Patients present with a wide array of symptoms and signs. These may include difficulty breathing, pain in the chest during breathing, and in more severe cases collapse, circulatory instability and sudden death. PE treatment requires rapid and accurate risk stratification before haemodynamic decompensation and the development of cardiogenic shock. Therapeutic application most often consists of an anticoagulant medication, such as heparin and warfarin, and rarely (in severe cases) with thrombolysis or surgery. In other, rarer forms of pulmonary embolism, material other than a blood clot is responsible; this may include fat or bone (usually in association with significant trauma), air (often when diving), clumped tumor cells, and amniotic fluid (affecting mothers during childbirth).