TY - JOUR T1 - Update on acute pulmonary embolism JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW SP - 137 LP - 147 DO - 10.1183/09059180.00004609 VL - 18 IS - 113 AU - O. Sanchez AU - B. Planquette AU - G. Meyer Y1 - 2009/09/01 UR - http://err.ersjournals.com/content/18/113/137.abstract N2 - The annual incidence of venous thromboembolic disease (VTE) is approximately one to two cases per 1,000 persons and is strongly age dependent, as the incidence rises to nearly 1% per year in those aged >75 yrs [1, 2]. A recent epidemiological study confirmed that VTE is a major public health burden with an estimated 370,000 related deaths in 2004 in six European countries [3]. Moreover, pulmonary embolism (PE) may lead to persistent chronic disease, i.e. chronic thromboembolic pulmonary hypertension, which can be severely disabling [4–8]. Recent published data on risk factors, diagnosis, prognosis and treatment of acute PE will be the main focus of this update. VTE is currently considered to be the result of an interaction between patient-related and setting-related risk factors [9]. Patient-related predisposing factors are usually permanent, whereas setting-related risk factors are more often temporary (table 1⇓). However, the predictive values of these factors are not equal and VTE can occur in patients without any identifiable predisposing factors.View this table:In this windowIn a new windowTable. 1— Predisposing risk factors for pulmonary embolism Pregnancy and post-partum period VTE is one of the leading causes of maternal morbidity and mortality. About two-thirds of VTE cases occur during pregnancy and one-third post-partum. A recent case–control study showed that the risk of VTE was increased five-fold (OR 4.6, 95% CI 2.7–7.8) during pregnancy and increased 60-fold (OR 60.1, 95% CI 26.5–135.9) during the first 3 months following delivery compared with nonpregnant females [10]. The risk was highest in the third trimester of pregnancy and during the first 6 weeks after delivery. The risk of thrombosis during pregnancy is affected by the presence of pro-thrombotic abnormalities. Females with Factor V Leiden or prothrombin 20210A, two common pro-thrombotic genetic variants, have a 30 to 50-fold increased risk of VTE during pregnancy and post-partum relative to … ER -