Pulmonary embolism

The incidence of pulmonary embolism (PE) is approximately 60 to 70/100.000 inhibitants/year. In hospitalized patients PE is the most frequently non-diagnozed cause of death, which occurs mainly early after onset of PE. Immobilization, surgery, old age, malignancies, hormonal factors as well as inherited or acquired thrombophilia are important risk factors. Diagnostic strategies include patient history and clinical evaluation, ECG, thorax radiography and laboratory tests (blood gas analysis, d-dimer, CK, troponin). Helical computed tomography (CT) is particularly suited for the evaluation of suspected PE in patients with serious cardiopulmonary disease. Alternatively, angiography and ventilation-perfusion szintigraphy may be used, however, both methods may have significant disadavantages as compared to helical CT. The therapy of PE stratifies the clinical grade and reaches from ambulant therapy with low-molecular-weight heparin to thrombolysis or embolectomy in massive pulmonary embolism.