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Pulmonary embolism is usually the consequence of a hypercoagulative state. This may be idiopathic, due to venous stasis from long trips, being bedridden after surgery, and certain medications and neoplastic processes.

An acute embolic process is often initially suspected clinically and chemically by sudden onset of shortness of breath, chest pain that is usually pleuritic in nature, increased O2 requirements, changes in the A-a gradient and an elevation in D-dimer levels.

CT angiography is the standard of care for diagnosis. The findings include a central filling defect surronded by enhanced blood within the pulmonary arteries or their branches. A specific protocol of contrast injection rate and timing must be employed.

The sensitivity and specificity of CT for diagnosis is 100% for the main pulmonary artery, 90% for the segmental branches and is less sensitive when subsegmental emboli are considered.

The treatment is anticoagulant therapy.