Pulmonary embolism in young women: statement of problem in internist’s point of view

the high morbidity and mortality in so-called "provoked" pulmonary embolism (PE) have recently attracted a lot of attention to this problem. In real clinical practice, there is a constant increase in the prevalence of PE, which to some extent is due to the improvement of its detection due to the introduction of modern methods of laboratory diagnostics and imaging, which made it possible to identify a larger number of clinically insignificant emboli of small branches of the pulmonary artery. Young women are more likely to be suspected of PE than age-matched men, and the risk modifiers are somewhat different from those in the male population. Therefore, the purpose of this article was to highlight the gender characteristics of venous thrombosis in general and PE, in particular, in women, with the description of risk factors inherent in the female population, as well as the stratification of PE and the justification of the choice of treatment strategy depending on risk groups and taking into account gender. After an analytical search of recent publications related to venous thromboembolism and PE in both men and women, female risk modifiers were detailed. It is noted that in the case of suspected PE, the pretest probability does not always take into account gender. Given that venous thromboembolism, unlike arterial thrombosis, occurs at a younger age, suspicion of PE in women is sometimes underestimated, and risk modifiers for thromboembolism in women are not always taken into account. Determination of D-dimer and troponin levels remain an important step in the diagnostic search today. The article shows gender differences in the level of troponin as a marker of right ventricular damage. Attention is paid to imaging research methods, in particular spiral computed tomography and its importance in the diagnosis of thromboembolic complications. The attention of specialists and the tactics of treatment selection, which is based on risk assessment and taking into account hemodynamic stability, are drawn.