Modern strategy for diagnosis and treatment of pulmonary embolism.

Various techniques are available for the diagnosis of pulmonary embolism (PE), including pulmonary angiography, perfusion-ventilation lung scanning, D-dimer measurement, venous ultrasonography and, most recently, helical computerized tomography of the chest. The advantages and disadvantages of these techniques, used alone or in combination, are briefly discussed. Studies have indicated that treatment with low-molecular-weight heparin (LMWH), as well as being more convenient to administer, is as safe and effective as standard heparin therapy in acute PE. However, the efficacy and safety of LMWH in patients with acute PE and haemodynamic instability requires verification. Finally, the indications of inferior vena caval filters and thrombolytic therapy are outlined.