Therapy for Pulmonary Embolism

DURING the past several years, there has been a growing awareness of the thromboembolic problem as a modern paradox: that as medical progress is being made, the incidence of thromboembolism is rising. The likely reason for this is that we are confronted with an older and sicker population who are subjected to prolonged periods of bed rest and more complex operations. From statistics, when both the primary and secondary, or contributory, causes of death are considered, pulmonary embolism may well be the most common cause of death in the hospital.1On the basis of reasonable estimates that fatal pulmonary embolism occurs in five patients per 1,000 inpatients2and nonfatal pulmonary embolism in 20 patients per 1,000 inpatients,3it can be estimated that approximately 142,000 patients suffer fatal pulmonary embolism and 568,000 suffer nonfatal pulmonary embolism each year in the United States. The mortality of untreated pulmonary embolism