{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:44:18Z","timestamp":1790840658352,"version":"4.1.0"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Angiol"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Over the last 20 years, there has been a progressive increase in the incidence of pulmonary embolism (PE) diagnosis in the United States, Europe, and Australia. Increased use of computed tomography pulmonary angiography has likely contributed in part to this rising incidence. However, it is pertinent to note that the burden of comorbidities associated with PE, such as malignancy, obesity, and advanced age, has also increased over the past 20 years. Time-trend analysis in North American, European, and Asian populations suggests that mortality rates associated with PE have been declining. The reported improved survival rates in PE over the past 20 years are likely, at least in part, to be the result of better adherence to guidelines, improved risk stratification, and enhanced treatment. Factors contributing to the development of venous thromboembolism (VTE) include stasis of blood, hypercoagulability, endothelial injury, and inflammation. In 70 to 80% of cases of PE, the thrombi embolizes from the proximal deep veins of the lower extremities and pelvis. Strong risk factors for VTE include lower extremity fractures and surgeries, major trauma, and hospitalization within the previous 3 months for acute myocardial infarction or heart failure with atrial fibrillation. Acute PE causes several pathophysiological responses including hypoxemia and right ventricle (RV) failure. The latter is a result of pulmonary artery occlusion and associated vasoconstriction. Hemodynamic compromise from RV failure is the principal cause of poor outcome in patients with acute PE.<\/jats:p>","DOI":"10.1055\/s-0044-1785487","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T23:18:02Z","timestamp":1712963882000},"page":"076-081","source":"Crossref","is-referenced-by-count":32,"title":["Epidemiology, Etiology, and Pathophysiology of Pulmonary Embolism"],"prefix":"10.1055","volume":"33","author":[{"given":"Catherine R.","family":"Glazier","sequence":"additional","affiliation":[{"name":"School of Medicine, University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Frank A.","family":"Baciewicz","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Wayne State University School of Medicine, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"issue":"13","key":"ref2","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1001\/jama.2022.16815","article-title":"Acute pulmonary embolism: a review","volume":"328","author":"Y Freund","year":"2022","journal-title":"JAMA"},{"issue":"08","key":"ref3","first-page":"e93","article-title":"Heart disease and stroke statistics-2023 update: a report from the American Heart Association","volume":"147","author":"C W Tsao","year":"2023","journal-title":"Circulation"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.thromres.2021.12.011","article-title":"Pulmonary embolism: age specific temporal trends in incidence and mortality in Denmark 1999-2018","volume":"210","author":"E Sonne-Holm","year":"2022","journal-title":"Thromb Res"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1183\/09031936.00194213","article-title":"Trends in hospital admissions for pulmonary embolism in Spain from 2002 to 2011","volume":"44","author":"J de Miguel-D\u00edez","year":"2014","journal-title":"Eur Respir J"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1160\/th15-02-0172","article-title":"Time trends and case fatality rate of in-hospital treated pulmonary embolism during 11 years of observation in Northwestern Italy","volume":"115","author":"F Dentali","year":"2016","journal-title":"Thromb Haemost"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.thromres.2013.04.032","article-title":"Trends in pulmonary embolism morbidity and mortality in Australia","volume":"132","author":"T P Shiraev","year":"2013","journal-title":"Thromb Res"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"f3368","DOI":"10.1136\/bmj.f3368","article-title":"When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found","volume":"347","author":"R S Wiener","year":"2013","journal-title":"BMJ"},{"issue":"09","key":"ref10","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1001\/archinternmed.2011.178","article-title":"Time trends in pulmonary embolism in the United States: evidence of overdiagnosis","volume":"171","author":"R S Wiener","year":"2011","journal-title":"Arch Intern Med"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1183\/20734735.0339-2018","article-title":"Overdiagnosis of pulmonary embolism: definition, causes and implications","volume":"15","author":"C C Dobler","year":"2019","journal-title":"Breathe (Sheff)"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1055\/s-0038-1642036","article-title":"Epidemiology, pathophysiology, and natural history of pulmonary embolism","volume":"35","author":"M Turetz","year":"2018","journal-title":"Semin Intervent Radiol"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1055\/s-0042-1756218","article-title":"Classification and stratification of pulmonary embolisms","volume":"31","author":"C Russell","year":"2022","journal-title":"Int J Angiol"},{"issue":"12","key":"ref14","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/jamaoncol.2019.2996","article-title":"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study","volume":"5","author":"C Fitzmaurice","year":"2019","journal-title":"JAMA Oncol"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/S2213-8587(19)30026-9","article-title":"The obesity transition: stages of the global epidemic","volume":"7","author":"L M Jaacks","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"S V Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S2213-2600(20)30417-3","article-title":"Age-sex specific pulmonary embolism-related mortality in the USA and Canada, 2000-18: an analysis of the WHO Mortality Database and of the CDC Multiple Cause of Death database","volume":"9","author":"S Barco","year":"2021","journal-title":"Lancet Respir Med"},{"issue":"06","key":"ref19","first-page":"428","article-title":"[Trends in mortality related to pulmonary embolism in the DACH countries]","volume":"117","author":"L Hobohm","year":"2022","journal-title":"Med Klin Intensivmed Notf Med"},{"issue":"18","key":"ref20","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1016\/j.jacc.2020.08.070","article-title":"Registry of arterial and venous thromboembolic complications in patients with COVID-19","volume":"76","author":"G Piazza","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.thromres.2022.02.008","article-title":"Deaths related to pulmonary embolism and cardiovascular events before and during the 2020 COVID-19 pandemic: an epidemiological analysis of data from an Italian high-risk area","volume":"212","author":"D Voci","year":"2022","journal-title":"Thromb Res"},{"issue":"18","key":"ref22","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/j.jacc.2020.09.543","article-title":"Thromboembolism and the pandemic","volume":"76","author":"R D McBane II","year":"2020","journal-title":"J Am Coll Cardiol"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/j.1365-2141.2008.07323.x","article-title":"Virchow and his triad: a question of attribution","volume":"143","author":"C N Bagot","year":"2008","journal-title":"Br J Haematol"},{"key":"ref25","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-87090-4_2","volume-title":"Epidemiology, pathophysiology and predisposing factors of pulmonary embolism and deep vein thrombosis","author":"D Nachman","year":"2022"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(20)32658-1","article-title":"Venous thromboembolism","volume":"398","author":"F Khan","year":"2021","journal-title":"Lancet"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1055\/s-0042-1756204","article-title":"Pathophysiology and management of pulmonary embolism","volume":"31","author":"I K Shah","year":"2022","journal-title":"Int J Angiol"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1111\/jth.12124","article-title":"Diagnostic management of acute deep vein thrombosis and pulmonary embolism","volume":"11","author":"M V Huisman","year":"2013","journal-title":"J Thromb Haemost"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"18028","DOI":"10.1038\/nrdp.2018.28","article-title":"Pulmonary embolism","volume":"4","author":"M V Huisman","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"ref30","first-page":"I9","article-title":"Risk factors for venous thromboembolism","volume":"107","author":"F A Anderson Jr","year":"2003","journal-title":"Circulation"},{"issue":"9012","key":"ref31","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1016\/S0140-6736(96)91013-2","article-title":"Resistance to activated protein C in an unselected population of patients with pulmonary embolism","volume":"347","author":"S Desmarais","year":"1996","journal-title":"Lancet"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.ccm.2010.06.004","article-title":"Venous thromboembolism in pregnancy","volume":"31","author":"P E Marik","year":"2010","journal-title":"Clin Chest Med"},{"issue":"05","key":"ref33","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/j.1538-7836.2009.03295.x","article-title":"Metabolic syndrome and risk of venous thromboembolism: longitudinal investigation of thromboembolism etiology","volume":"7","author":"L M Steffen","year":"2009","journal-title":"J Thromb Haemost"},{"issue":"08","key":"ref34","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.3390\/medicina58081078","article-title":"Pathophysiological aspects of aging in venous thromboembolism: an update","volume":"58","author":"D Akrivou","year":"2022","journal-title":"Medicina (Kaunas)"},{"issue":"07","key":"ref35","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1111\/j.1525-1497.2006.00458.x","article-title":"The Worcester Venous Thromboembolism study: a population-based study of the clinical epidemiology of venous thromboembolism","volume":"21","author":"F A Spencer","year":"2006","journal-title":"J Gen Intern Med"},{"issue":"03","key":"ref36","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/0002-9149(71)90116-0","article-title":"The hemodynamic response to pulmonary embolism in patients without prior cardiopulmonary disease","volume":"28","author":"K M McIntyre","year":"1971","journal-title":"Am J Cardiol"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/S0008-6363(00)00168-1","article-title":"Pathophysiology and treatment of haemodynamic instability in acute pulmonary embolism: the pivotal role of pulmonary vasoconstriction","volume":"48","author":"Y M Smulders","year":"2000","journal-title":"Cardiovasc Res"}],"container-title":["International Journal of Angiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1785487.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T16:54:34Z","timestamp":1730825674000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1785487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,12]]},"references-count":33,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2024,6,5]]},"published-print":{"date-parts":[[2024,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1785487","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1061-1711","1615-5939"],"issn-type":[{"value":"1061-1711","type":"print"},{"value":"1615-5939","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,12]]}}}