Pulmonary embolism: the role of emergency scan and intervening radiology in medium-high-risk patients with pulmonary embolism

Pulmonary embolism (PE) is a relative common cardiovascular emergency. Computed tomography (CT) angiography has became the method of choice for suspected PE in routine clinical practice but CT should not be the first-line test for all patients, except suspected high-risk patients and high clinical probability or “PE likely” patients. In these situations emergency phisician ‘s echographic cardiac study can be particularly helpful for a rapid patient management. The two cases prove the helpful use of echografic cardiac study in emergency room and rivet the necessity of an aggressive therapeutic management with primary aim of flow restoration through occluded pulmonary arteries. Percutaneous catheter embolectomy and fragmentation of proximal pulmonary arterial clots may be considerer, with multidisciplinary approach, as an alternative when thrombolysis is absolutely contraindicated or has failed, or as an alternative to surgical treatment.