Peer Reviewed
Feature Article Cardiovascular medicine

Improving long-term outcomes following acute pulmonary embolism

Christopher Cy Wong, Vincent Chow, Leonard Kritharides, Austin Cc Ng
Abstract

Acute pulmonary embolism (PE) can result in complications many years after the initial event. An understanding of the long-term outcomes in patients following a PE is important to improve their management.

Key Points
  • Pulmonary embolism (PE) has been thought of as an acute condition with few long-term sequelae; however, data from recent studies have revealed an effect on mortality many years after the original insult.
  • Patients who experience an episode of PE are predisposed to later venous thromboembolic (VTE) events: VTE provoked by cancer is likely to have the highest recurrence rate, whereas VTE after surgery has the lowest recurrence rate.
  • GPs have a vital role in the intermediate- to long-term anticoagulation management of patients who have had a PE.
  • Chronic thromboembolic pulmonary hypertension should be considered in patients with previous PE or VTE who present with ongoing or unexplained dyspnoea, exercise intolerance, atypical chest pain, syncope or peripheral oedema.
  • There is increasing evidence of persistent functional and right ventricular impairment among long-term survivors of submassive PE.
  • Patients who have had a PE have been found to have a threefold increase in 30-year mortality compared with controls, even after adjustment for comorbidities.

    Picture credit: © Scott Bodell

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