Diagnosis and treatment of pulmonary embolism: a multidisciplinary approach

Federico Lavorini, Vitantonio Di Bello, Maria Luisa De Rimini, Giovanni Lucignani, Letizia Marconi, Gualtiero Palareti, Raffaele Pesavento, Domenico Prisco, Massimo Santini, Nicola Sverzellati, Antonio Palla, Massimo Pistolesi

The diagnosis of pulmonary embolism (PE) is frequently considered in patients presenting to the emergency department or when hospitalized. Although early treatment is highly effective, PE is underdiagnosed and, therefore, the disease remains a major health problem. Since symptoms and signs are non specific and the consequences of anticoagulant treatment are considerable, objective tests to either establish or refute the diagnosis have become a standard of care. Diagnostic strategy should be based on clinical evaluation of the probability of PE. The accuracy of diagnostic tests for PE are high when the results are concordant with the clinical assessment. Additional testing is necessary when the test results are inconsistent with clinical probability. The present review article represents the consensus-based recommendations of the Interdisciplinary Association for Research in Lung Disease (AIMAR) multidisciplinary Task Force for diagnosis and treatment of PE. The aim of this review is to provide clinicians a practical diagnostic and therapeutic management approach using evidence from the literature.