Acute pulmonary embolism is a leading cause of cardiovascular death . It is associated with significant in-hospital mortality and represents a major challenge to health systems worldwide .

Vascular Medicine — Research & Evidence

Vascular Medicine

L1 subspecialty spine topic for Vascular Medicine (seeded from backend/data/cardiology_taxonomy.yaml).

Also called PAD, aortic disease, VTE, pulmonary embolism

Sources: 12 new papers · 5 key papers · updated Oct 20, 2026

Overview

Unverified · drafted by AI from the sources cited below

Definition

Acute pulmonary embolism is a leading cause of cardiovascular death.1

Diagnosis and risk stratification

Evaluation of pulmonary embolism includes assessment of clinical probability and, if indicated, d-dimer testing.1 Pretest probability scores including the Wells clinical prediction rule and the revised Geneva score act as first line assessments to determine the need for further diagnostic testing.2 For imaging, the Pulmonary Embolism Reporting and Data System provides a standardized framework for reporting acute pulmonary embolism at CT and MR angiography.3 Risk stratification tools such as the Hestia criteria, Pulmonary Embolism Severity Index, and simplified Pulmonary Embolism Severity Index help to identify patients appropriate for outpatient management.2

Treatment

Most patients with low-risk pulmonary embolism can be treated with oral anticoagulants.1 In patients with acute, intermediate-risk pulmonary embolism, ultrasound-facilitated, catheter-directed fibrinolysis plus anticoagulation led to a lower risk of the composite of pulmonary embolism-related death, cardiopulmonary decompensation or collapse, or symptomatic recurrence of pulmonary embolism within 7 days than anticoagulation alone.2

Key papers

Pulmonary Embolism

New England Journal of Medicine — Kahn S

195 citations · 2022 · among the most cited on Vascular Medicine

Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism

New England Journal of Medicine — Rosenfield K

83 citations · 2026 · among the most cited on Vascular Medicine

Comparison of international guideline recommendations for the diagnosis of pulmonary embolism

The Lancet Haematology — Falster C

54 citations · 2023 · among the most cited on Vascular Medicine

Sex, Racial, and Geographic Disparities in Pulmonary Embolism–related Mortality Nationwide

Annals of the American Thoracic Society — Zghouzi M

44 citations · 2023 · among the most cited on Vascular Medicine

Pulmonary Embolism and Heart Failure: A Reappraisal

Cardiac failure review — Arrigo M

30 citations · 2021 · among the most cited on Vascular Medicine

How this page is built

A clinical question appears here only when its condition matches this topic, an outcome and a comparator were extracted from the studies, at least two studies and a patient count are on file, and the certainty is low or higher.

Supports benefit, no benefit shown, and mixed describe the direction of the measured effect. No benefit shown means the evidence does not support a benefit. It is not a finding of harm. Too little evidence means the question did not clear that bar.

Study count, RCT count, and patient count are separate. The patient total adds only studies that are linked into a study family and whose sample size is not flagged as implausible. A reversal is listed only when at least one randomized trial sits on each side of the change.

The overview is drafted from the guideline recommendations, trials, papers, and questions on this page, and every sentence has to cite one of them. It stays unverified until an NPI-verified clinician or a Synapse admin approves it. Approving records that person's name.