Pulmonary Embolism Management involves the rapid recognition, risk stratification and treatment of thrombotic obstruction in the pulmonary arterial tree, most often arising from deep-vein thrombosis of the lower limbs or pelvis. Because pulmonary embolism is a leading cause of sudden cardiovascular death, clinicians increasingly rely on structured protocols and expert-led cardiology conference discussions to refine diagnostic pathways, imaging selection and therapeutic decision-making. Presentations range from mild pleuritic pain and transient dyspnea to catastrophic collapse with cardiogenic shock, so a systematic approach to venous thromboembolism care is critical for safe and timely intervention.

This session begins by outlining typical and atypical clinical presentations, including unexplained tachycardia, hypoxemia, syncope, hemoptysis and right-sided chest discomfort. Special attention is given to high-risk populations such as postoperative patients, those with active malignancy, pregnancy, prior venous thrombosis or prolonged immobility. Participants explore pre-test probability tools, D-dimer interpretation and bedside red flags that trigger urgent diagnostic imaging rather than watchful waiting.

Imaging strategies are reviewed in detail. CT pulmonary angiography remains the first-line modality for most patients, providing direct visualisation of emboli, right-ventricular dilatation and clot burden. The role of V/Q scanning is discussed for individuals with renal dysfunction, contrast allergy or pregnancy, while echocardiography is highlighted for its value in unstable patients, where signs of right-ventricular strain can justify emergent reperfusion therapy even before definitive CT confirmation. Laboratory markers such as troponin and natriuretic peptides are examined for their value in risk stratification rather than diagnosis alone.

Therapeutic options are structured according to risk category. Low-risk patients generally receive anticoagulation with direct oral anticoagulants, low-molecular-weight heparin or vitamin K antagonists, with clear guidance on duration of therapy and follow-up. Intermediate-risk patients require close hemodynamic and right-ventricular monitoring, with careful selection for escalation to systemic or catheter-directed thrombolysis. High-risk or massive pulmonary embolism demands rapid coordinated response, incorporating thrombolytics, mechanical thrombectomy or surgical embolectomy alongside vasopressor and ventilatory support.

Prevention of recurrence forms a major focus of this session. Clinicians review indications for extended anticoagulation, thrombophilia testing, malignancy screening and lifestyle modification, including mobility strategies and smoking cessation. Chronic complications such as chronic thromboembolic pulmonary hypertension are discussed with an emphasis on early recognition, referral for pulmonary endarterectomy or balloon pulmonary angioplasty and long-term right-heart follow-up. Future directions include more targeted lytic agents, refined catheter systems, AI-supported imaging interpretation and wearable technologies that support early detection of decompensation. By the end of the session, participants will have a practical, evidence-informed framework for managing pulmonary embolism across the full spectrum of clinical severity. The overall goal is to integrate guideline-based therapy with individualised risk assessment so that every patient receives timely, proportionate treatment while minimising bleeding complications and optimising long-term functional recovery.