Pulmonary Embolism as a Cardiovascular Emergency: Optimizing Early Diagnosis and Management in the Emergency Department

Background/Objectives: Pulmonary embolism (PE) is the third leading cause of cardiovascular mortality, with significant diagnostic and therapeutic challenges in the emergency department. Utilizing appropriate and accurate screening and risk stratification tools optimizes clinical decision making and patient outcomes. This review seeks to discuss current diagnostic tools, different treatment modalities utilized in the ED to reduce mortality and morbidity in patients who present with PE, and to further highlight the outcomes associated with such treatment modalities. Methods: We reviewed current literature regarding the epidemiology, diagnosis, risk stratification, and management of PE, with a focus on clinical decision tools and advanced therapeutic interventions. Specific attention was given to diagnostic algorithms, and guidelines regarding risk stratification methods as well as treatment options including catheter-directed thrombolysis (CDT), mechanical thrombectomy, systemic thrombolysis, and ultrasound-assisted thrombolysis (USAT). Results: Accurate utilization of risk stratification tools has been shown to improve patient-specific treatment and provide a better insight into patient outcomes. Interventional therapies such as CDT and USAT have demonstrated reduced mortality and morbidity in high- and intermediate-risk PE patients when compared to systemic anticoagulation alone. There is also future discussion on how to improve risk stratification to continue to reduce patient mortality and morbidity as well as reduce the risk of sequelae and side effects. Conclusions: Optimizing the diagnosis and management of PE through effective risk stratification and advanced therapeutic options continues to evolve. Future research will focus on refining interventional therapies, enhancing risk assessment models, and preventing long-term sequelae, ultimately aiming to improve both short- and long-term patient outcomes.