Decoding Pulmonary Embolism: Pathophysiology, Diagnosis, and Treatment

Author:

Peracaula Miriam1ORCID,Sebastian Laura23,Francisco Iria4,Vilaplana Marc Bonnin23,Rodríguez-Chiaradía Diego A.56ORCID,Tura-Ceide Olga167

Affiliation:

1. Translational Research Group on Cardiovascular Respiratory Diseases (CAREs), Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI-CERCA), 17190 Girona, Spain

2. Department of Medical Sciences, Faculty of Medicine, University of Girona, 17003 Girona, Spain

3. Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt, and the Girona Biomedical Research Institute (IDIBGI-CERCA), 17190 Girona, Spain

4. Department of Internal Medicine, Dr. Josep Trueta University Hospital de Girona, 17190 Girona, Spain

5. Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra (UPF), Barcelona Biomedical Research Park (PRBB), 08003 Barcelona, Spain

6. Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), 28029 Madrid, Spain

7. Department of Biological Sciences, Faculty of Science, University of Girona, 17003 Girona, Spain

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.

Funder

Institute of Health Carlos III

European Social Fund

The Spanish Society of Respiratory Medicine

Catalan Society of Pneumology

Spanish Society of Cardiology

Fondo Europeo de Desarrollo Regional

Publisher

MDPI AG

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