Main Lines of Management of Pulmonary embolism based on ESC Clinical Practice Guidelines 2014

1. Main Lines of
Management of
Pulmonary embolism
ESC Clinical Practice
Guidelines 2014
Ahmed Elmoghazy
Internal Medicine Resident,
MRI, Alexandria University

2. Epidemiology
 Among patients with proximal DVT, about 50% have an associated,
usually clinically asymptomatic PE at lung scan. In about 70% of patients
with PE, DVT can be found in the lower limbs if sensitive diagnostic
methods are used.
 Proximal DVT is one that is located in the popliteal, femoral, or iliac veins.
Isolated distal DVT has no proximal component, is located below the
knee, and is confined to the calf veins (peroneal, posterior, anterior tibial,
and muscular veins)
 PE occurs 3 – 7 days after the onset of DVT, and may be fatal within 1 h
after the onset of symptoms in 10% of cases, the diagnosis going
clinically unrecognized in most fatal cases.
 The risk of death related to the initial acute episode or to recurrent PE is
greater in patients who present with PE than in those who present with
DVT.
 The proportion of patients with idiopathic or unprovoked PE was about
20% in the International Cooperative Pulmonary Embolism Registry
(ICOPER).