Pharmacologic Treatment of Pulmonary Embolism

Bruria Hirsh Raccah*, Yosef Kalish, Refat Jabara, Eyal Herzog, Batia Roth Jelinek

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

1 Scopus citations


Acute pulmonary embolism (PE) is a life-threatening condition with a considerable morbidity and mortality. The pharmacologic treatment of PE consists of an initial treatment phase, followed by an acute phase lasting 3–6 months and a chronic or extended phase, aimed for long term prevention of recurrence. The initial phase should be started immediately after the diagnosis is confirmed. We risk stratify the patients based on their clinical presentation, their right ventricle function and their level of cardiac biomarkers. For high-risk patients and for selected patients with intermediate high risk, the treatment is composed of a combination of anticoagulation and thrombolytic therapy (preferably directed locally to the pulmonary artery by a catheter). For lower risk stable patients and for intermediate low risk patients anticoagulation alone is the treatment of choice. The range of anticoagulants consists of the heparins, mostly low molecular weight heparins (LMWH), vitamin K antagonists (VKAs), and the direct oral anticoagulants (DOACs). The pharmacological properties of the different agents are presented in this chapter with their advantages in different clinical settings. The decision about extended duration therapy is based on the balance between the risk for recurrence and the bleeding risk. The choice of a specific anticoagulant, tailored according to the patient's characteristics, co-morbidities, and preferences.

Original languageEnglish
Title of host publicationPulmonary Embolism
PublisherSpringer International Publishing
Number of pages28
ISBN (Electronic)9783030870904
ISBN (Print)9783030870898
StatePublished - 1 Jan 2021

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.


  • Anticoagulation
  • Direct oral anticoagulants
  • Pulmonary embolism
  • Thrombolysis
  • Warfarin


Dive into the research topics of 'Pharmacologic Treatment of Pulmonary Embolism'. Together they form a unique fingerprint.

Cite this