Practical guide to management after an acute pulmonary embolism

Alikhan, Raza, Howard, Luke S., Johnson, Martin, Sweeney, Shruti, Kiely, David G. and Pepke-Zaba, Joanna 2025. Practical guide to management after an acute pulmonary embolism. BMJ Open Respiratory Research 12 (1) , e003028. 10.1136/bmjresp-2024-003028

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Abstract

Follow-up after acute pulmonary embolism (PE) is important to assess recovery, consider the need for on-going anticoagulation and identify chronic thromboembolic pulmonary hypertension (CTEPH), a rare but serious complication of PE. 16 dilemmas in the follow-up of acute PE were identified by a steering committee of four pulmonologists and a haematologist with interest in PE and/or CTEPH. Current literature was reviewed and a practical approach suggested based on expert consensus. Dilemmas discussed included: (1) how to manage a breathless patient; (2) what to do if CTEPH is suspected; (3) the difference between CTEPH and post-PE syndrome, (4) testing for thrombophilia, (5) when to investigate for cancer, (6) anticoagulation duration and dose, (7) approaches to discussions and decision-making with respect to anticoagulation, (8) use of aspirin and whether antiplatelet therapy should be stopped during anticoagulation and (9) advice for patients on discharge from hospital at 3 months and information for first-degree relatives. Given the occurrence of complications that may require assessment, follow-up of patients post-PE should be systematic and consider the individual needs of the patient.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: Title: cc by-nc, Type: cc by-nc
Publisher:	BMJ Publishing Group
Date of First Compliant Deposit:	7 October 2025
Date of Acceptance:	12 June 2025
Last Modified:	07 Oct 2025 13:15
URI:	https://orca.cardiff.ac.uk/id/eprint/181531

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