Decoding Pulmonary Embolism: Pathophysiology, Diagnosis, and Treatment

Abstract

Pulmonary Embolism (PE) is a life-threatening condition initiated by the presence of blood clots in the pulmonary arteries, leading to severe morbidity and mortality. Underlying mechanisms involve endothelial dysfunction, including impaired blood flow regulation, a pro-thrombotic state, inflammation, heightened oxidative stress, and altered vascular remodeling. These mechanisms contribute to vascular diseases stemming from PE, such as recurrent thromboembolism, chronic thromboembolic pulmonary hypertension, post-thrombotic syndrome, right heart failure, and cardiogenic shock. Detailing key risk factors and utilizing hemodynamic stability-based categorization, the review aims for precise risk stratification by applying established diagnostic tools and scoring systems. This article explores both conventional and emerging biomarkers as potential diagnostic tools. Additionally, by synthesizing existing knowledge, it provides a comprehensive outlook of the current enhanced PE management and preventive strategies. The conclusion underscores the need for future research to improve diagnostic accuracy and therapeutic effectiveness in PE

This study has been funded by Institute of Health Carlos III through the Miguel Servet type grants CP17/00114, CPII22/00006 (Co-funded by European Social Fund " Investing in your future), The Spanish Society of Respiratory Medicine (SEPAR2019), Catalan Society of Pneumology (SOCAP2019), and from the Institute of Health Carlos III (PI21/01212, PI22/00133), and Spanish Society of Cardiology (SEC/FEC-INV-BAS 23/06). M. Peracaula was a recipient of Institute of Health Carlos III grant (FI22/00133). Cofunding was provided by the Fondo Europeo de Desarrollo Regional (FEDER); “Una manera de hacer Europa”