Pulmonary embolism: Approach to clinical manifestations and therapeutic management

Abstract

Pulmonary embolism (PE) is a serious condition resulting from the obstruction of the pulmonary arteries by thrombi, usually derived from deep vein thrombosis. The pathology is diagnostically challenging due to its clinical variability and similarity to other respiratory and cardiovascular conditions. The increased incidence of PE is driven by factors such as aging, obesity and sedentary lifestyle, highlighting the need to review diagnostic and therapeutic approaches. This study aims to review the clinical manifestations of PE and discuss modern therapeutic approaches, emphasizing diagnostic innovations and new management strategies. The methodology included a systematic review of the literature in databases such as PubMed, Medline, SciELO and Google Scholar, selecting articles from the last ten years in Portuguese or English focused on PE. Clinical manifestations of PE range from sudden dyspnea to hemodynamic collapse, with chest computed tomography angiography being the main diagnostic method. Treatment varies according to severity, with thrombolysis reserved for severe cases and anticoagulation as the mainstay of management, using low molecular weight heparin and direct oral anticoagulants. Long-term follow-up is vital to prevent chronic complications such as chronic thromboembolic pulmonary hypertension. Successful management of PE depends on a multidisciplinary approach and rapid identification and personalized treatment, considering the patient's risk factors to improve clinical outcomes.