Management of Acute Pulmonary Embolism: Clinical Challenges and Therapeutic Strategies

Acute pulmonary embolism (PE) is one of the main cardiovascular emergencies, representing the third leading cause of death from vascular causes worldwide.Despite diagnostic advances, early recognition and appropriate management of PE still pose significant challenges to clinical practice, especially in cases classified as intermediate risk, where the therapeutic decision must be individualized and based on multiple parameters.This article carries out a narrative review of the literature, bringing together the most up-to-date evidence on the diagnosis, risk stratification and treatment of PE, with an emphasis on controversial aspects of management and strategies aimed at reducing morbidity and mortality.It highlights the central role of assessing right ventricular function, the careful use of biomarkers, the positive impact of multidisciplinary teams (PERT) and therapeutic innovations such as low-dose thrombolysis and catheter-directed interventions.The importance of longitudinal monitoring to prevent chronic complications, such as thromboembolic pulmonary hypertension, is also highlighted.Given the high prevalence and complexity of PE, technical mastery combined with an integrated, evidence-based approach is fundamental to optimizing clinical outcomes.