BMJ  2006;332:156-160 (21 January), doi:10.1136/bmj.332.7534.156

Practice

Pulmonary embolism in hospital practice

¹ Department of Respiratory Medicine, Royal Berkshire and Battle Hospitals NHS Trust, Reading RG1 5AN gracevrobinson@yahoo.co.uk

The first 150 words of the full text of this article appear below.

A pulmonary embolism is an obstruction of part of the pulmonary vascular tree, usually caused by a thrombus that has travelled from a distant site—for example, the deep veins in the leg. The annual incidence is 60-70 per 100 000^{1 w1}; it is a common cause of breathlessness and pleuritic pain.

Pulmonary embolism has an untreated mortality of about 30% and is the commonest cause of death after elective surgery (accounting for up to 15% of all post-operative deaths).^{2 w2} It is the commonest cause of maternal death in the United Kingdom.³

Who gets it?

Most thrombi are generated in the deep venous system of the lower leg and pelvis. Venous stasis is increased by immobility and dehydration, which leads to the accumulation of clotting factors and platelets. Up to 50% of leg thrombi embolise; clots above the knee do so more commonly than clots below the knee.^{4 w3} Large clots may lodge at the . . . [Full text of this article]

"Economy class syndrome"

Rare causes of pulmonary embolism

Diagnosing pulmonary embolism

History and symptoms

Examination

Investigations

First line investigations
Second line investigations

How should pulmonary embolism be treated?

Supportive treatment
Anticoagulation

Follow-up

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