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More than 600,000 people are diagnosed with pulmonary embolism (PE) each year. Approximately 15% of these patients die of PE-associated complications within the first 3 months after diagnosis. This American Journal of Medicine Update includes 3 articles that address different aspects of diagnosis and treatment of venous thromboembolism (VTE) with a focus on PE. The first article, from Dr Kim Askew, Assistant Professor of Emergency Medicine at the Wake Forest University School of Medicine, addresses diagnosis and treatment of PE and provides a thorough review of the clinical presentation, diagnostic modalities, and treatment guidelines for low- and intermediate-risk (nonmassive) PE. The second article is from Drs Bret Nicks, Assistant Medical Director at the Wake Forest University School of Medicine, and David Manthey, Associate Professor at the Wake Forest University School of Medicine. It addresses diagnosis and treatment of deep vein thrombosis (DVT). Diagnostic testing is often necessary for definitive diagnosis of DVT. Of those patients presenting with symptoms suggestive of PE, <30% actually have imaging-detected PE. Dr Nicks discusses the importance of an evidence-based approach to assess the need for diagnostic testing and potential treatment. The final article in the update is from Dr James O'Neill, Assistant Professor of Medicine at Wake Forest University Health Sciences. In his article entitled “Risk Stratification and Treatment of Massive Pulmonary Embolism,” Dr O’Neill defines massive and submassive PE, discusses risk stratification of patients with submassive PE, reviews recommended treatment options, and reviews data on the efficacy of thrombolysis in different risk-stratification groups. This trio of reviews provides clinicians with an overview of diagnosis and treatment of DVT and PE as well as tools for stratifying risk and utilizing evidence-based approaches for the treatment of PE. |