Pulmonary Embolism: Symptoms, Diagnosis, and Treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Pulmonary embolism is a blockage of a lung artery by a blood clot. Symptoms, Wells score, D-dimers, anticoagulants, and management in Quebec.\">\n<meta name=\"keywords\" content=\"embolie pulmonaire traitement, embolie pulmonaire sympt\u00f4mes, embolie pulmonaire diagnostic, embolie pulmonaire score Wells, embolie pulmonaire D-dim\u00e8res, embolie pulmonaire anticoagulants, embolie pulmonaire thrombolyse, embolie pulmonaire Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n.co-wrap * { font-family: 'Poppins', sans-serif; box-sizing: border-box; }\n.co-wrap { max-width: 1100px; margin: 0 auto; padding: 30px 0 60px; }\n.co-label { font-family: 'Cinzel', serif; font-size: 14px; font-weight: bold; letter-spacing: 1px; text-transform: uppercase; color: #4D6577; margin-bottom: 14px; display: block; }\n.co-wrap h1 { font-size: 32px; font-weight: 500; color: #323C52; margin: 0 0 22px; line-height: 1.2; }\n.co-intro { font-size: 16px; line-height: 1.75; color: #4D6577; margin-bottom: 36px; padding-bottom: 32px; border-bottom: 1px solid rgba(77,101,119,.2); }\n.co-wrap h2 { font-size: 20px; font-weight: 600; color: #323C52; margin: 32px 0 12px; }\n.co-wrap p { font-size: 15px; color: #4D6577; line-height: 1.7; margin-bottom: 14px; }\n.co-list { list-style: none; padding: 0; margin: 12px 0 24px; }\n.co-list li { font-size: 15px; color: #4D6577; padding: 10px 14px 10px 38px; margin-bottom: 8px; border-radius: 6px; position: relative; background: rgba(77,101,119,.06); border-left: 3px solid #4D6577; }\n.co-list li::before { content: \"\u2713\"; position: absolute; left: 12px; font-weight: 700; color: #4D6577; }\n.co-table { width: 100%; border-collapse: collapse; margin: 14px 0 22px; font-size: 14px; border-radius: 8px; overflow: hidden; table-layout: fixed; }\n.co-table thead tr { background: #323C52; color: #fff; }\n.co-table thead th { padding: 11px 16px; text-align: left; font-weight: 600; font-size: 13px; }\n.co-table tbody tr:nth-child(even) { background: rgba(77,101,119,.06); }\n.co-table tbody tr:nth-child(odd) { background: #fff; }\n.co-table td { padding: 10px 16px; color: #4D6577; border-bottom: 1px solid rgba(77,101,119,.12); font-size: 14px; vertical-align: top; }\n.co-table td:first-child { font-weight: 600; color: #323C52; }\n.co-infobox { display: flex; gap: 12px; background: rgba(77,101,119,.06); border-radius: 8px; border-left: 4px solid #4D6577; padding: 14px 18px; margin: 18px 0 28px; font-size: 14px; color: #4D6577; line-height: 1.65; }\n.co-infobox .ico { font-size: 18px; flex-shrink: 0; }\n.co-urgence { background: #fff8f8; border-left: 5px solid #c0392b; border-radius: 6px; padding: 20px 26px; margin: 24px 0 32px; }\n.co-urgence .co-urgence-titre { font-size: 13px; font-weight: 700; color: #c0392b; letter-spacing: 1.5px; text-transform: uppercase; margin-bottom: 10px; }\n.co-urgence p { color: #5a2020; font-size: 14px; margin: 0 0 10px; line-height: 1.7; }\n.co-urgence p:last-child { margin-bottom: 0; }\n.co-disclaimer { font-size: 13px; color: #8a9aaa; font-style: italic; border-top: 1px solid rgba(77,101,119,.15); padding-top: 24px; margin-top: 40px; line-height: 1.6; }\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n <span class=\"co-label\">Internal Medicine & Pulmonology & Emergency Medicine<\/span>\n <h1>Pulmonary embolism<\/h1>\n\n <div class=\"co-intro\">\n Pulmonary embolism (PE) is an acute obstruction of one or more pulmonary arteries by thrombotic material\u2014in more than 90% of cases, a thrombus originating from deep vein thrombosis (DVT) of the lower extremities or pelvis. Together with DVT, it constitutes the two clinical manifestations of venous thromboembolism (VTE), a unified pathophysiological entity. PE is the third leading cause of cardiovascular mortality after myocardial infarction and stroke, with an estimated incidence of 60 to 70 cases per 100,000 inhabitants per year. Its short-term mortality varies considerably depending on severity: less than 1% for low-risk PEs treated early, it reaches 30 to 50% for massive PEs with untreated cardiogenic shock. The pathophysiology is based on Virchow\u2019s triad\u2014venous stasis, hypercoagulability, and endothelial injury\u2014and the resulting pulmonary arterial obstruction leads to increased pulmonary vascular resistance \u2192 right ventricular (RV) dilation and dysfunction \u2192 reduced cardiac output \u2192 hypoxemia due to shunting and increased ventilatory dead space \u2192 shock if the obstruction is massive. Risk stratification upon admission\u2014distinguishing high-risk PE (shock or hypotension), intermediate-risk (RD dysfunction without shock), and low-risk cases\u2014is fundamental because it determines the urgency and intensity of treatment.\n <\/div>\n\n <h2>Clinical presentation, risk factors, and diagnostic approach<\/h2>\n <ul class=\"co-list\">\n <li><strong>Clinical Presentation \u2014 From Common Syndrome to Life-Threatening Emergency:<\/strong> sudden unexplained dyspnea (the most common symptom\u201480% of cases); pleural chest pain (reactive pleurisy\u2014peripheral pulmonary infarction\u201450% of cases); sinus tachycardia (>100 bpm\u2014most common physical sign); hemoptysis (hemorrhagic pulmonary infarction\u201410\u201315% of PE cases); syncope or presyncope (massive PE\u2014acute right ventricular dysfunction\u201410% of PE cases); signs of concomitant DVT (pain + unilateral calf edema \u2014 30% of PE cases); insidious forms: progressive exertional dyspnea, unexplained tachycardia, exacerbation of heart failure or COPD \u2014 PE should be considered in any unexplained cardiorespiratory presentation<\/li>\n <li><strong>Key risk factors:<\/strong> recent major surgery (<3 months\u2014especially orthopedic: total hip or knee replacement\u2014risk \u00d7 40\u201360 without prophylaxis); prolonged immobilization (bed rest >3 days, air travel >8 hours, limb paralysis); active cancer (paraneoplastic hypercoagulability\u2014risk \u00d7 4\u20136\u201420% of PE cases have underlying cancer); pregnancy and postpartum (risk \u00d7 4\u20135\u2014PE is the leading cause of direct maternal mortality in Canada); combined oral contraceptives (risk \u00d7 3\u20134\u2014especially if smoking + obesity); history of VTE (risk of recurrence: 10% at 1 year, 30% at 5 years); hereditary thrombophilia (Factor V Leiden, prothrombin G20210A mutation, protein C\/S or antithrombin deficiency) or acquired thrombophilia (antiphospholipid syndrome); obesity (BMI >30); chronic heart or respiratory failure; central venous catheter<\/li>\n <li><strong>Wells Score and Pretest Probability Stratification<\/strong> clinical signs of DVT (3 pts) + PE more likely than the alternative diagnosis (3 pts) + heart rate >100 bpm (1.5 pts) + immobilization or surgery within 4 weeks (1.5 pts) + history of DVT\/PE (1.5 pts) + hemoptysis (1 pt) + active cancer (1 pt); score <2 = low probability; score 2\u20136 = moderate probability; score >6 = high probability; PERC rule (Pulmonary Embolism Rule-out Criteria): if all 8 PERC criteria are negative in a patient with low pretest probability \u2192 PE ruled out without D-dimer testing (age <50 years + HR <100 bpm + SpO\u2082 \u226595% + no DVT + no hemoptysis + no recent use of estrogen + no history of DVT\/PE + no recent surgery or trauma requiring hospitalization)<\/li>\n <li><strong>Diagnostic workup :<\/strong> D-dimers (high-sensitivity ELISA): reference value <500 \u00b5g\/L \u2014 negative predictive value >99.1% if pretest probability is low or moderate \u2192 negative D-dimers = PE ruled out; age-adjusted threshold: in those >50 years old, use age \u00d7 10 \u00b5g\/L as the threshold (reduces false positives without loss of sensitivity \u2014 Douma 2010 BMJ); Positive D-dimers or high probability \u2192 chest CT angiography (CTA): gold standard \u2014 sensitivity 83\u2013100% (%), specificity 89\u201398% (%) \u2014 visualizes clots down to the segmental arteries; V\/Q (ventilation\/perfusion) lung scintigraphy: alternative to CT angiography if contraindicated for iodine (allergy, severe chronic kidney disease) + in pregnant women (lower breast radiation exposure) + if chronic post-embolic pulmonary hypertension (CPEH) is suspected; lower extremity venous ultrasound (proximal DVT): useful adjunct if CT angiography is inconclusive; ECG: sinus tachycardia (most common sign) + S1Q3T3 (15 % \u2014 not very specific) + incomplete BBD + T-wave inversion in V1\u2013V4 (right ventricular overload); echocardiography (ETT): assessment of RV function (dilatation + hypokinesis + McConnell\u2019s sign) + estimation of PAPS + search for in situ thrombus + hemodynamic status \u2192 essential in high-risk PE<\/li>\n <\/ul>\n\n <h2>Treatment<\/h2>\n <table class=\"co-table\">\n <colgroup><col style=\"width:200px;\"><col style=\"width:42%;\"><col><\/colgroup>\n <thead>\n <tr><th>Treatment<\/th><th>Mechanism, diagram, and terms<\/th><th>Duration, effectiveness, and precautions<\/th><\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Anticoagulation \u2014 standard treatment<br><small style=\"font-weight:400;color:#7a8fa0;\">Acute Coronary Syndrome on 1st line - heparin if high risk or pregnant<\/small><\/td>\n <td>Direct Oral Anticoagulants (DOACs) \u2014 ESC 2019 first-line treatment \/ Thrombosis Canada for non-massive PE: rivaroxaban (Xarelto) 15 mg BID for 21 days then 20 mg QD (high-dose initial regimen without prior heparin); apixaban (Eliquis) 10 mg BID for 7 days then 5 mg BID (same principle \u2013 without prior heparin); dabigatran (Pradaxa) 150 mg BID after 5\u201310 days of initial heparin; edoxaban (Lixiana) 60 mg QD after 5\u201310 days of initial heparin; low molecular weight heparin (LMWH) + vitamin K antagonist (warfarin): classic treatment still used if DOACs are contraindicated (severe CKD GFR <30 + active cancer + pregnancy + antiphospholipid syndrome) \u2014 LMWH: enoxaparin (Lovenox) 1 mg\/kg SC BID or 1.5 mg\/kg QD; tinzaparin 175 IU\/kg QD \u2014 warfarin: target INR 2\u20133 \u2014 overlap LMWH + warfarin until 2 consecutive INRs \u22652 at 24h interval; IV unfractionated heparin (UFH): indicated for high-risk PE or severe renal impairment \u2014 bolus 80 IU\/kg + continuous infusion 18 IU\/kg\/h \u2014 target aPTT 60\u2013100 sec (1.5\u20132.5 \u00d7 control)<\/td>\n <td>DOACs are superior to warfarin for PE (40\u201350% reduction in bleeding risk with non-inferior anticoagulant efficacy\u2014van Es 2014 meta-analysis, Lancet Haematol); contraindications for DOACs: eGFR <15\u201330 mL\/min (depending on the drug) + pregnancy + breastfeeding + antiphospholipid syndrome (IgG and IgM positive \u2014 increased risk of recurrence with DOACs vs. warfarin \u2014 ESC\/ISTH recommendation) + active cancer (LMWH or rivaroxaban\/apixaban according to the CARAVAGGIO\/SELECT-D study) ; reversibility: andexanet alfa (Andexxa) for rivaroxaban\/apixaban + idarucizumab (Praxbind) for dabigatran \u2014 available in hospitals for major bleeding; Duration of anticoagulation depending on the context: PE caused by a major reversible transient factor (surgery, immobilization) \u2192 3 months; unprovoked PE (idiopathic) \u2192 minimum 3 months followed by reassessment of the risk of recurrence vs. hemorrhage; PE in active cancer \u2192 indefinite duration as long as the cancer is active<\/td>\n <\/tr>\n <tr>\n <td>Systemic thrombolysis<br><small style=\"font-weight:400;color:#7a8fa0;\">Massive pulmonary embolism with shock - life-threatening emergency<\/small><\/td>\n <td>Formal indication: High-risk PE with cardiac arrest + hemodynamic instability (SBP 15 min otherwise unexplained + cardiogenic shock with signs of organ failure); agent: alteplase (tPA \u2014 Activase) 100 mg IV over 2 hours (10 mg IV bolus over 1\u20132 min + 90 mg IV over 2h) \u2014 ESC 2019 reference protocol; in case of cardiac arrest: alteplase 50 mg IV bolus + external chest compressions for a minimum of 90 min (lyse the thrombus during resuscitation); absolute contraindications: hemorrhagic stroke or ischemic stroke <3 months + recent intracranial or spinal surgery + recent severe head trauma + active non-compressible bleeding; relative contraindications (to be weighed against life risk): major surgery <3 weeks + recent gastrointestinal bleeding <1 month + pregnancy + thrombocytopenia 180\/110); after thrombolysis: resume anticoagulation with IV UFH without bolus upon completion of infusion (aPTT <80 sec before resuming) or as soon as aPTT <2 \u00d7 control if infusion stopped<\/td>\n <td>Systemic thrombolysis reduces mortality by 50\u201360% in massive ischemic stroke with shock (Marti meta-analysis, 2015 \u2014 NNT \u2248 8 to prevent one death) at the cost of a major bleeding risk of 10\u201320 per 1,000 (hemorrhagic stroke 1\u20133 per 1,000); in high-intermediate-risk PE (right ventricular dysfunction + elevated troponin) without shock \u2014 rescue thrombolysis: reserved for hemodynamic deterioration while on anticoagulation alone (PEITHO trial 2014 \u2014 reduction in early complications but excess hemorrhagic strokes with systematic thrombolysis); low-dose thrombolysis: alteplase 50 mg over 2 hours (MOPETT study 2013 \u2014 submassive PE \u2014 reduction in PAPS and HPEC at 28 months \u2014 limited data); the decision to perform thrombolysis in intermediate PE must be individualized \u2014 consultation between emergency physician, intensivist, and pulmonologist<\/td>\n <\/tr>\n <tr>\n <td>Surgical embolectomy and catheter-directed<br><small style=\"font-weight:400;color:#7a8fa0;\">Alternatives to systemic thrombolysis<\/small><\/td>\n <td>Surgical embolectomy under CPB: indicated if thrombolysis is contraindicated or has failed + massive PE with shock + thrombus in situ in the right heart + patent foramen ovale with paradoxical emboli \u2014 emergency cardiothoracic surgery + cardiopulmonary bypass (ECC) + pulmonary artery thrombus extraction \u2014 success rate 80\u201390% in expert centers \u2014 operative mortality 20\u201330% (versus >50% without treatment); catheter-directed thrombolysis (EKOS + CDT): multi-lumen catheter positioned in the pulmonary artery via a percutaneous approach (femoral vein \u2192 OD \u2192 PA) \u2014 local infusion of low-dose alteplase (1 mg\/h\/catheter \u00d7 12\u201324 h) \u00b1 low-frequency ultrasound (EKOS system \u2014 ULTIMA trial 2014 \u2014 SEATTLE II 2015 \u2014 reduction in mean PAP + improvement in RV\/LV ratio at 24 hours without excessive bleeding vs. systemic thrombolysis); catheter-directed thrombus aspiration (Penumbra Indigo, AngioVac): less well-evaluated option \u2014 specialized centers; caval filters (filter in the inferior vena cava): indicated if PE is confirmed + anticoagulation is strictly contraindicated (major active bleeding) or recurrence of PE despite optimal anticoagulation \u2014 retrievable filters preferred over permanent ones \u2014 removal as soon as anticoagulation is possible<\/td>\n <td>PERT (Pulmonary Embolism Response Teams) \u2014 interdisciplinary teams available in several university hospitals in Quebec (CHUM, MUHC, IUCPQ) \u2014 allow for rapid, collaborative decision-making (emergency physician + pulmonologist + hematologist + cardiologist + vascular surgeon) for high- and intermediate-high-risk PEs \u2014 their implementation is associated with reduced in-hospital mortality in several cohorts; permanent vena cava filters increase the long-term risk of DVT (Decousus PREPIC trial 1998) and are not a substitute for anticoagulation \u2014 their indication should be regularly reassessed with removal if possible; CPAP and non-invasive ventilation can worsen the hemodynamic status in massive PEs (increased RV afterload) \u2014 prioritize high-flow O\u2082 or orotracheal intubation with protective settings (avoid high pressures).<\/td>\n <\/tr>\n <tr>\n <td>Duration of anticoagulation and prevention of recurrence<br><small style=\"font-weight:400;color:#7a8fa0;\">Individualized decision \u2014 bleeding benefit\/risk balance<\/small><\/td>\n <td>Context-based decision algorithm: PE caused by a major transient surgical factor (surgery \u226530 min + general anesthesia + bed rest >3 days) \u2192 stop at 3 months \u2014 low risk of recurrence (3 % at 5 years); PE caused by a minor transient factor (travel, brief immobilization, contraceptives) \u2192 3 months \u2014 intermediate risk (15 % at 5 years); Unprovoked PE (idiopathic \u2014 no identified triggering factor) \u2192 minimum 3 months, followed by assessment of the benefit-risk ratio of prolongation \u2014 HERDOO2 score in women (hyperpigmentation + edema + lower limb erythema + post-anticoagulation D-dimers + obesity + age \u226565 years) \u2014 HAS-BLED score for bleeding risk \u2014 ESC recommendation: indefinite prolonged anticoagulation if low bleeding risk + first unprovoked episode + no contraindications; PE in active cancer \u2192 LMWH or apixaban\/rivaroxaban (CARAVAGGIO 2020 \u2014 HOKUSAI VTE Cancer) as long as cancer is active or being treated; major thrombophilia (antiphospholipid syndrome, antithrombin deficiency) \u2192 indefinite anticoagulation; recurrent PE \u2192 indefinite anticoagulation unless major bleeding risk<\/td>\n <td>Unprovoked PE recurs in 30\u201350% of cases at 10 years without prolonged anticoagulation\u2014the decision to discontinue anticoagulation at 3 months should be made in consultation with the patient (preferences + individual bleeding risk + quality of life on anticoagulation); reduced dose after 6 months: apixaban 2.5 mg twice daily (AMPLIFY-EXT trial \u2014 67% reduction in recurrences vs. placebo) or rivaroxaban 10 mg once daily (EINSTEIN CHOICE \u2014 74% reduction vs. aspirin) \u2014 options for indefinite continuation with lower bleeding risk; aspirin alone (100 mg \u00d7 1\/day) is insufficient to prevent PE recurrence (only a 30% reduction \u2014 ASPIRE\/WARFASA) vs. reduced-dose OAC \u2014 do not use aspirin as an alternative to anticoagulants; post-anticoagulation D-dimer testing (1 month after discontinuation): Positive D-dimer levels \u2192 doubled risk of recurrence \u2192 strong argument for extending anticoagulation (DOLORES\/PROLONG study)<\/td>\n <\/tr>\n <tr>\n <td>Outpatient management and post-embolic pulmonary hypertension<br><small style=\"font-weight:400;color:#7a8fa0;\">Low-risk EP \u2014 long-term sequelae<\/small><\/td>\n <td>Outpatient treatment or early discharge from the emergency department for low-risk cases: simplified PESI (Pulmonary Embolism Severity Index) score = 0 (age <80 years + no cancer + HR <110 + SVR \u2265100 + SpO\u2082 \u226590 % + no heart failure or COPD) \u2192 low-risk PE \u2192 outpatient treatment possible + ACOD immediately; Hestia criteria (12 exclusion criteria for outpatient treatment) \u2014 if all negative \u2192 discharge possible; 30-day recurrence and mortality rates for outpatient treatment of low-risk PE: <1\u20132% (Aujesky 2011 Lancet \u2014 non-inferior to hospitalization); chronic thromboembolic pulmonary hypertension (CTEPH): long-term sequela \u2014 organized thrombus + pulmonary vascular remodeling \u2192 progressive obstruction of the pulmonary arteries \u2192 pulmonary hypertension (mean PAP >25 mmHg on right heart catheterization) \u2014 incidence: 0.5\u20133.8 per 1,000 PE cases at 2 years; presentation: progressive exertional dyspnea + exercise intolerance + signs of chronic cor pulmonale; diagnosis: V\/Q scan (first step \u2014 high sensitivity) + CT angiography + pulmonary catheterization; standard surgical treatment: pulmonary endarterectomy (PEA) \u2014 Jamieson procedure \u2014 expert centers (Toronto General Hospital \u2014 top Canadian center) + riociguat (Adempas \u2014 soluble guanylate cyclase stimulator) if inoperable or residual HPTEC post-PEA<\/td>\n <td>HPTEC is underdiagnosed\u2014any patient with PE and persistent dyspnea lasting >3 months who is on optimal anticoagulation should undergo a screening V\/Q scan; PAH is curable in 70\u201380% of operable cases (normalization of pulmonary pressures)\u2014operative mortality is 2\u20135% in expert centers; riociguat (Adempas) is the only drug treatment approved by Health Canada for inoperable HPTEC\u2014reimbursed by RAMQ under certain conditions; cardiopulmonary rehabilitation after PE is recommended for patients with persistent deconditioning or CTEPH \u2014 improves functional capacity and quality of life; 6-minute walk test (6MWT) + echocardiography + NT-proBNP: follow-up evaluations at 3 and 6 months after PE to screen for CTEPH and assess RV recovery<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2139\ufe0f<\/span>\n <span><strong>Thrombophilia testing - when to prescribe it:<\/strong> A thrombophilia workup (Factor V Leiden, prothrombin G20210A mutation, protein C, protein S, antithrombin, antiphospholipid antibodies\u2014lupus anticoagulant + anticardiolipin IgG\/IgM + anti-beta2-GP1) is recommended in cases of unprovoked PE before age 50, a first-degree family history of VTE, recurrent PE or DVT, thrombosis in an unusual site (mesenteric, caval, cerebral veins), or suspected antiphospholipid syndrome. It should be performed at least 3 months after the acute event and at a distance from anticoagulation (warfarin falsely alters protein C and S levels; DOACs can interfere with some functional coagulation tests). A positive result modifies the duration of anticoagulation but should not delay treatment of the acute event.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Emergency \u2014 Massive pulmonary embolism and shock<\/div>\n <p>Dial <strong>911<\/strong> immediately if: <strong>Sudden severe shortness of breath + chest pain + SpO\u2082 <90% 1\u20133 minutes + tachycardia >120 bpm<\/strong> pulmonary embolism until proven otherwise \u2014 transfer to ER.<\/p>\n <p><strong>Hypotension (SBP < 90 mmHg) + syncope + signs of shock<\/strong> (pallor, mottling, altered consciousness) in this context \u2192 massive PE \u2192 emergency thrombolysis or surgical embolectomy for life-threatening condition \u2014 high-flow O\u2082 + IV access + call for resuscitation team.<\/p>\n <p><strong>Patient known for anticoagulation for PE with sudden respiratory worsening<\/strong> \u2192 Embolic recurrence or bleeding on anticoagulation - urgent evaluation.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron physicians evaluate patients presenting with symptoms suggestive of pulmonary embolism (unexplained shortness of breath, chest pain, tachycardia), apply validated diagnostic algorithms (Wells score, D-dimers, CT angiography referral), initiate anticoagulation, and provide outpatient follow-up for low-risk PEs treated at home. Post-PE follow-up, including monitoring for CTEPH and optimal anticoagulation duration, is coordinated with the pulmonology and internal medicine teams. Consultations are available at our service points in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is provided for informational purposes only and does not substitute for the advice of a qualified healthcare professional. Any suspicion of pulmonary embolism constitutes a medical emergency requiring immediate hospital evaluation.<\/p>\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron M\u00e9decine interne & Pneumologie & M\u00e9decine d’urgence Embolie pulmonaire L’embolie pulmonaire (EP) est une obstruction aigu\u00eb d’une ou plusieurs art\u00e8res pulmonaires par un mat\u00e9riel thrombotique \u2014 dans plus de 90 % des cas un thrombus provenant d’une thrombose veineuse profonde (TVP) des membres inf\u00e9rieurs ou… <a href=\"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Pulmonary Embolism: Symptoms, Diagnosis, and Treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron","_metasync_otto_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","_metasync_otto_og_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","_metasync_otto_twitter_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","_metasync_otto_twitter_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron","_aioseo_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charge au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-06-13T19:45:41+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24534","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...\" \/>\n\t<meta name=\"robots\" content=\"max-snippet:1, max-image-preview:large, max-video-preview:1\" \/>\n\t<meta name=\"google-site-verification\" content=\"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM\" \/>\n\t<meta name=\"msvalidate.01\" content=\"3225E6935FC4F40C7DDCE56C37141BA8\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO Pro (AIOSEO) 4.9.8\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Clinique Omicron - Clinique M\u00e9dicale\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron\" \/>\n\t\t<meta property=\"og:description\" content=\"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...\" \/>\n\t\t<meta property=\"og:url\" content=\"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/\" \/>\n\t\t<meta property=\"og:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"og:image:secure_url\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"article:published_time\" content=\"2026-03-01T02:54:08+00:00\" \/>\n\t\t<meta property=\"article:modified_time\" content=\"2026-03-08T23:06:16+00:00\" \/>\n\t\t<meta property=\"article:publisher\" content=\"https:\/\/facebook.com\/Clinique Omicron\" \/>\n\t\t<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n\t\t<meta name=\"twitter:site\" content=\"@Clinique%20Omicron\" \/>\n\t\t<meta name=\"twitter:title\" content=\"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron\" \/>\n\t\t<meta name=\"twitter:description\" content=\"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...\" \/>\n\t\t<meta name=\"twitter:creator\" content=\"@Clinique%20Omicron\" \/>\n\t\t<meta name=\"twitter:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<script type=\"application\/ld+json\" class=\"aioseo-schema\">\n\t\t\t{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#breadcrumblist\",\"itemListElement\":[{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\",\"nextItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#listItem\",\"name\":\"Embolie pulmonaire : sympt\\u00f4mes, diagnostic et traitement | Clinique Omicron\"}},{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#listItem\",\"position\":2,\"name\":\"Embolie pulmonaire : sympt\\u00f4mes, diagnostic et traitement | Clinique Omicron\",\"previousItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"name\":\"Accueil\"}}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#webpage\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/\",\"name\":\"Embolie pulmonaire : sympt\\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron\",\"description\":\"L'embolie pulmonaire est une obstruction art\\u00e9rielle pulmonaire par un caillot sanguin. Sympt\\u00f4mes, score de Wells, D-dim\\u00e8res, anticoagulants et prise en charg...\",\"inLanguage\":\"en-CA\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#breadcrumblist\"},\"datePublished\":\"2026-02-28T22:54:08-04:00\",\"dateModified\":\"2026-03-08T19:06:16-04:00\"},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/\",\"name\":\"Clinique Omicron\",\"description\":\"Clinique M\\u00e9dicale\",\"inLanguage\":\"en-CA\",\"publisher\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#organization\"}}]}\n\t\t<\/script>\n\t\t\r\n\t\t<title>Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron<\/title>\n\n","aioseo_head_json":{"title":"Pulmonary Embolism: Symptoms, Diagnosis, and Treatment | Brossard | Omicron Clinic","description":"Pulmonary embolism is a pulmonary artery obstruction caused by a blood clot. Symptoms, Wells score, D-dimers, anticoagulants, and management...","canonical_url":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/","robots":"max-snippet:1, max-image-preview:large, max-video-preview:1","keywords":"","webmasterTools":{"google-site-verification":"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM","msvalidate.01":"3225E6935FC4F40C7DDCE56C37141BA8","miscellaneous":""},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"BreadcrumbList","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#breadcrumblist","itemListElement":[{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","position":1,"name":"Accueil","item":"https:\/\/cliniqueomicron.ca\/en","nextItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#listItem","name":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron"}},{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#listItem","position":2,"name":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron","previousItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","name":"Accueil"}}]},{"@type":"WebPage","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#webpage","url":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/","name":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron","description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","inLanguage":"en-CA","isPartOf":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#website"},"breadcrumb":{"@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#breadcrumblist"},"datePublished":"2026-02-28T22:54:08-04:00","dateModified":"2026-03-08T19:06:16-04:00"},{"@type":"WebSite","@id":"https:\/\/cliniqueomicron.ca\/en\/#website","url":"https:\/\/cliniqueomicron.ca\/en\/","name":"Clinique Omicron","description":"Clinique M\u00e9dicale","inLanguage":"en-CA","publisher":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#organization"}}]},"og:locale":"en_US","og:site_name":"Clinique Omicron - Clinique M\u00e9dicale","og:type":"article","og:title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","og:description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","og:url":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/","og:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","og:image:secure_url":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","article:published_time":"2026-03-01T02:54:08+00:00","article:modified_time":"2026-03-08T23:06:16+00:00","article:publisher":"https:\/\/facebook.com\/Clinique Omicron","twitter:card":"summary_large_image","twitter:site":"@Clinique%20Omicron","twitter:title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","twitter:description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","twitter:creator":"@Clinique%20Omicron","twitter:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg"},"aioseo_meta_data":{"post_id":"24534","title":"Pulmonary Embolism: Symptoms, Diagnosis, and Treatment | Brossard | Omicron Clinic","description":"Pulmonary embolism is a pulmonary artery obstruction caused by a blood clot. Symptoms, Wells score, D-dimers, anticoagulants, and management...","keywords":null,"keyphrases":{"focus":{"keyphrase":"embolie","score":75,"analysis":{"keyphraseInTitle":{"score":9,"maxScore":9,"error":0},"keyphraseInDescription":{"score":9,"maxScore":9,"error":0},"keyphraseLength":{"score":9,"maxScore":9,"error":0,"length":1},"keyphraseInURL":{"score":5,"maxScore":5,"error":0},"keyphraseInIntroduction":{"score":9,"maxScore":9,"error":0},"keyphraseInSubHeadings":{"score":3,"maxScore":9,"error":1},"keyphraseInImageAlt":[],"keywordDensity":{"type":"high","score":0,"maxScore":9,"error":1}}},"additional":[]},"primary_term":null,"canonical_url":null,"og_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","og_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","og_object_type":"default","og_image_type":"default","og_image_url":null,"og_image_width":null,"og_image_height":null,"og_image_custom_url":null,"og_image_custom_fields":null,"og_video":"","og_custom_url":null,"og_article_section":null,"og_article_tags":null,"twitter_use_og":true,"twitter_card":"summary_large_image","twitter_image_type":"default","twitter_image_url":null,"twitter_image_custom_url":null,"twitter_image_custom_fields":null,"twitter_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","twitter_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","schema":{"blockGraphs":[],"customGraphs":[],"default":{"data":{"Article":[],"Course":[],"Dataset":[],"FAQPage":[],"Movie":[],"Person":[],"Product":[],"ProductReview":[],"Car":[],"Recipe":[],"Service":[],"SoftwareApplication":[],"WebPage":[]},"graphName":"WebPage","isEnabled":true},"graphs":[]},"schema_type":"default","schema_type_options":null,"pillar_content":false,"robots_default":false,"robots_noindex":false,"robots_noarchive":false,"robots_nosnippet":false,"robots_nofollow":false,"robots_noimageindex":false,"robots_noodp":false,"robots_notranslate":false,"robots_max_snippet":"1","robots_max_videopreview":"1","robots_max_imagepreview":"large","priority":null,"frequency":"default","local_seo":null,"seo_analyzer_scan_date":"2026-04-24 08:12:30","breadcrumb_settings":null,"limit_modified_date":false,"reviewed_by":null,"open_ai":null,"ai":{"faqs":[],"keyPoints":[],"titles":[],"descriptions":[],"socialPosts":{"email":[],"linkedin":[],"twitter":[],"facebook":[],"instagram":[]}},"created":"2026-03-01 03:25:32","updated":"2026-06-13 15:45:41"},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t<a href=\"https:\/\/cliniqueomicron.ca\/en\" title=\"Accueil\">Accueil<\/a>\n<\/span><span class=\"aioseo-breadcrumb-separator\">\u203a<\/span><span class=\"aioseo-breadcrumb\">\n\tEmbolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron\n<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Accueil","link":"https:\/\/cliniqueomicron.ca\/en"},{"label":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron","link":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/"}],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24534","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24534"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24534\/revisions"}],"predecessor-version":[{"id":28643,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24534\/revisions\/28643"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24534"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

\n\t\t\t\t

\n\t\t\t\t\t

\n\t\t\t\t

\n\t\t\t\t\t\n\n\n\n\nPulmonary Embolism: Symptoms, Diagnosis, and Treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Pulmonary embolism is a blockage of a lung artery by a blood clot. Symptoms, Wells score, D-dimers, anticoagulants, and management in Quebec.\">\n<meta name=\"keywords\" content=\"embolie pulmonaire traitement, embolie pulmonaire sympt\u00f4mes, embolie pulmonaire diagnostic, embolie pulmonaire score Wells, embolie pulmonaire D-dim\u00e8res, embolie pulmonaire anticoagulants, embolie pulmonaire thrombolyse, embolie pulmonaire Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n.co-wrap * { font-family: 'Poppins', sans-serif; box-sizing: border-box; }\n.co-wrap { max-width: 1100px; margin: 0 auto; padding: 30px 0 60px; }\n.co-label { font-family: 'Cinzel', serif; font-size: 14px; font-weight: bold; letter-spacing: 1px; text-transform: uppercase; color: #4D6577; margin-bottom: 14px; display: block; }\n.co-wrap h1 { font-size: 32px; font-weight: 500; color: #323C52; margin: 0 0 22px; line-height: 1.2; }\n.co-intro { font-size: 16px; line-height: 1.75; color: #4D6577; margin-bottom: 36px; padding-bottom: 32px; border-bottom: 1px solid rgba(77,101,119,.2); }\n.co-wrap h2 { font-size: 20px; font-weight: 600; color: #323C52; margin: 32px 0 12px; }\n.co-wrap p { font-size: 15px; color: #4D6577; line-height: 1.7; margin-bottom: 14px; }\n.co-list { list-style: none; padding: 0; margin: 12px 0 24px; }\n.co-list li { font-size: 15px; color: #4D6577; padding: 10px 14px 10px 38px; margin-bottom: 8px; border-radius: 6px; position: relative; background: rgba(77,101,119,.06); border-left: 3px solid #4D6577; }\n.co-list li::before { content: \"\u2713\"; position: absolute; left: 12px; font-weight: 700; color: #4D6577; }\n.co-table { width: 100%; border-collapse: collapse; margin: 14px 0 22px; font-size: 14px; border-radius: 8px; overflow: hidden; table-layout: fixed; }\n.co-table thead tr { background: #323C52; color: #fff; }\n.co-table thead th { padding: 11px 16px; text-align: left; font-weight: 600; font-size: 13px; }\n.co-table tbody tr:nth-child(even) { background: rgba(77,101,119,.06); }\n.co-table tbody tr:nth-child(odd) { background: #fff; }\n.co-table td { padding: 10px 16px; color: #4D6577; border-bottom: 1px solid rgba(77,101,119,.12); font-size: 14px; vertical-align: top; }\n.co-table td:first-child { font-weight: 600; color: #323C52; }\n.co-infobox { display: flex; gap: 12px; background: rgba(77,101,119,.06); border-radius: 8px; border-left: 4px solid #4D6577; padding: 14px 18px; margin: 18px 0 28px; font-size: 14px; color: #4D6577; line-height: 1.65; }\n.co-infobox .ico { font-size: 18px; flex-shrink: 0; }\n.co-urgence { background: #fff8f8; border-left: 5px solid #c0392b; border-radius: 6px; padding: 20px 26px; margin: 24px 0 32px; }\n.co-urgence .co-urgence-titre { font-size: 13px; font-weight: 700; color: #c0392b; letter-spacing: 1.5px; text-transform: uppercase; margin-bottom: 10px; }\n.co-urgence p { color: #5a2020; font-size: 14px; margin: 0 0 10px; line-height: 1.7; }\n.co-urgence p:last-child { margin-bottom: 0; }\n.co-disclaimer { font-size: 13px; color: #8a9aaa; font-style: italic; border-top: 1px solid rgba(77,101,119,.15); padding-top: 24px; margin-top: 40px; line-height: 1.6; }\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n <span class=\"co-label\">Internal Medicine & Pulmonology & Emergency Medicine<\/span>\n <h1>Pulmonary embolism<\/h1>\n\n <div class=\"co-intro\">\n Pulmonary embolism (PE) is an acute obstruction of one or more pulmonary arteries by thrombotic material\u2014in more than 90% of cases, a thrombus originating from deep vein thrombosis (DVT) of the lower extremities or pelvis. Together with DVT, it constitutes the two clinical manifestations of venous thromboembolism (VTE), a unified pathophysiological entity. PE is the third leading cause of cardiovascular mortality after myocardial infarction and stroke, with an estimated incidence of 60 to 70 cases per 100,000 inhabitants per year. Its short-term mortality varies considerably depending on severity: less than 1% for low-risk PEs treated early, it reaches 30 to 50% for massive PEs with untreated cardiogenic shock. The pathophysiology is based on Virchow\u2019s triad\u2014venous stasis, hypercoagulability, and endothelial injury\u2014and the resulting pulmonary arterial obstruction leads to increased pulmonary vascular resistance \u2192 right ventricular (RV) dilation and dysfunction \u2192 reduced cardiac output \u2192 hypoxemia due to shunting and increased ventilatory dead space \u2192 shock if the obstruction is massive. Risk stratification upon admission\u2014distinguishing high-risk PE (shock or hypotension), intermediate-risk (RD dysfunction without shock), and low-risk cases\u2014is fundamental because it determines the urgency and intensity of treatment.\n <\/div>\n\n <h2>Clinical presentation, risk factors, and diagnostic approach<\/h2>\n <ul class=\"co-list\">\n <li><strong>Clinical Presentation \u2014 From Common Syndrome to Life-Threatening Emergency:<\/strong> sudden unexplained dyspnea (the most common symptom\u201480% of cases); pleural chest pain (reactive pleurisy\u2014peripheral pulmonary infarction\u201450% of cases); sinus tachycardia (>100 bpm\u2014most common physical sign); hemoptysis (hemorrhagic pulmonary infarction\u201410\u201315% of PE cases); syncope or presyncope (massive PE\u2014acute right ventricular dysfunction\u201410% of PE cases); signs of concomitant DVT (pain + unilateral calf edema \u2014 30% of PE cases); insidious forms: progressive exertional dyspnea, unexplained tachycardia, exacerbation of heart failure or COPD \u2014 PE should be considered in any unexplained cardiorespiratory presentation<\/li>\n <li><strong>Key risk factors:<\/strong> recent major surgery (<3 months\u2014especially orthopedic: total hip or knee replacement\u2014risk \u00d7 40\u201360 without prophylaxis); prolonged immobilization (bed rest >3 days, air travel >8 hours, limb paralysis); active cancer (paraneoplastic hypercoagulability\u2014risk \u00d7 4\u20136\u201420% of PE cases have underlying cancer); pregnancy and postpartum (risk \u00d7 4\u20135\u2014PE is the leading cause of direct maternal mortality in Canada); combined oral contraceptives (risk \u00d7 3\u20134\u2014especially if smoking + obesity); history of VTE (risk of recurrence: 10% at 1 year, 30% at 5 years); hereditary thrombophilia (Factor V Leiden, prothrombin G20210A mutation, protein C\/S or antithrombin deficiency) or acquired thrombophilia (antiphospholipid syndrome); obesity (BMI >30); chronic heart or respiratory failure; central venous catheter<\/li>\n <li><strong>Wells Score and Pretest Probability Stratification<\/strong> clinical signs of DVT (3 pts) + PE more likely than the alternative diagnosis (3 pts) + heart rate >100 bpm (1.5 pts) + immobilization or surgery within 4 weeks (1.5 pts) + history of DVT\/PE (1.5 pts) + hemoptysis (1 pt) + active cancer (1 pt); score <2 = low probability; score 2\u20136 = moderate probability; score >6 = high probability; PERC rule (Pulmonary Embolism Rule-out Criteria): if all 8 PERC criteria are negative in a patient with low pretest probability \u2192 PE ruled out without D-dimer testing (age <50 years + HR <100 bpm + SpO\u2082 \u226595% + no DVT + no hemoptysis + no recent use of estrogen + no history of DVT\/PE + no recent surgery or trauma requiring hospitalization)<\/li>\n <li><strong>Diagnostic workup :<\/strong> D-dimers (high-sensitivity ELISA): reference value <500 \u00b5g\/L \u2014 negative predictive value >99.1% if pretest probability is low or moderate \u2192 negative D-dimers = PE ruled out; age-adjusted threshold: in those >50 years old, use age \u00d7 10 \u00b5g\/L as the threshold (reduces false positives without loss of sensitivity \u2014 Douma 2010 BMJ); Positive D-dimers or high probability \u2192 chest CT angiography (CTA): gold standard \u2014 sensitivity 83\u2013100% (%), specificity 89\u201398% (%) \u2014 visualizes clots down to the segmental arteries; V\/Q (ventilation\/perfusion) lung scintigraphy: alternative to CT angiography if contraindicated for iodine (allergy, severe chronic kidney disease) + in pregnant women (lower breast radiation exposure) + if chronic post-embolic pulmonary hypertension (CPEH) is suspected; lower extremity venous ultrasound (proximal DVT): useful adjunct if CT angiography is inconclusive; ECG: sinus tachycardia (most common sign) + S1Q3T3 (15 % \u2014 not very specific) + incomplete BBD + T-wave inversion in V1\u2013V4 (right ventricular overload); echocardiography (ETT): assessment of RV function (dilatation + hypokinesis + McConnell\u2019s sign) + estimation of PAPS + search for in situ thrombus + hemodynamic status \u2192 essential in high-risk PE<\/li>\n <\/ul>\n\n <h2>Treatment<\/h2>\n <table class=\"co-table\">\n <colgroup><col style=\"width:200px;\"><col style=\"width:42%;\"><col><\/colgroup>\n <thead>\n <tr><th>Treatment<\/th><th>Mechanism, diagram, and terms<\/th><th>Duration, effectiveness, and precautions<\/th><\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Anticoagulation \u2014 standard treatment<br><small style=\"font-weight:400;color:#7a8fa0;\">Acute Coronary Syndrome on 1st line - heparin if high risk or pregnant<\/small><\/td>\n <td>Direct Oral Anticoagulants (DOACs) \u2014 ESC 2019 first-line treatment \/ Thrombosis Canada for non-massive PE: rivaroxaban (Xarelto) 15 mg BID for 21 days then 20 mg QD (high-dose initial regimen without prior heparin); apixaban (Eliquis) 10 mg BID for 7 days then 5 mg BID (same principle \u2013 without prior heparin); dabigatran (Pradaxa) 150 mg BID after 5\u201310 days of initial heparin; edoxaban (Lixiana) 60 mg QD after 5\u201310 days of initial heparin; low molecular weight heparin (LMWH) + vitamin K antagonist (warfarin): classic treatment still used if DOACs are contraindicated (severe CKD GFR <30 + active cancer + pregnancy + antiphospholipid syndrome) \u2014 LMWH: enoxaparin (Lovenox) 1 mg\/kg SC BID or 1.5 mg\/kg QD; tinzaparin 175 IU\/kg QD \u2014 warfarin: target INR 2\u20133 \u2014 overlap LMWH + warfarin until 2 consecutive INRs \u22652 at 24h interval; IV unfractionated heparin (UFH): indicated for high-risk PE or severe renal impairment \u2014 bolus 80 IU\/kg + continuous infusion 18 IU\/kg\/h \u2014 target aPTT 60\u2013100 sec (1.5\u20132.5 \u00d7 control)<\/td>\n <td>DOACs are superior to warfarin for PE (40\u201350% reduction in bleeding risk with non-inferior anticoagulant efficacy\u2014van Es 2014 meta-analysis, Lancet Haematol); contraindications for DOACs: eGFR <15\u201330 mL\/min (depending on the drug) + pregnancy + breastfeeding + antiphospholipid syndrome (IgG and IgM positive \u2014 increased risk of recurrence with DOACs vs. warfarin \u2014 ESC\/ISTH recommendation) + active cancer (LMWH or rivaroxaban\/apixaban according to the CARAVAGGIO\/SELECT-D study) ; reversibility: andexanet alfa (Andexxa) for rivaroxaban\/apixaban + idarucizumab (Praxbind) for dabigatran \u2014 available in hospitals for major bleeding; Duration of anticoagulation depending on the context: PE caused by a major reversible transient factor (surgery, immobilization) \u2192 3 months; unprovoked PE (idiopathic) \u2192 minimum 3 months followed by reassessment of the risk of recurrence vs. hemorrhage; PE in active cancer \u2192 indefinite duration as long as the cancer is active<\/td>\n <\/tr>\n <tr>\n <td>Systemic thrombolysis<br><small style=\"font-weight:400;color:#7a8fa0;\">Massive pulmonary embolism with shock - life-threatening emergency<\/small><\/td>\n <td>Formal indication: High-risk PE with cardiac arrest + hemodynamic instability (SBP 15 min otherwise unexplained + cardiogenic shock with signs of organ failure); agent: alteplase (tPA \u2014 Activase) 100 mg IV over 2 hours (10 mg IV bolus over 1\u20132 min + 90 mg IV over 2h) \u2014 ESC 2019 reference protocol; in case of cardiac arrest: alteplase 50 mg IV bolus + external chest compressions for a minimum of 90 min (lyse the thrombus during resuscitation); absolute contraindications: hemorrhagic stroke or ischemic stroke <3 months + recent intracranial or spinal surgery + recent severe head trauma + active non-compressible bleeding; relative contraindications (to be weighed against life risk): major surgery <3 weeks + recent gastrointestinal bleeding <1 month + pregnancy + thrombocytopenia 180\/110); after thrombolysis: resume anticoagulation with IV UFH without bolus upon completion of infusion (aPTT <80 sec before resuming) or as soon as aPTT <2 \u00d7 control if infusion stopped<\/td>\n <td>Systemic thrombolysis reduces mortality by 50\u201360% in massive ischemic stroke with shock (Marti meta-analysis, 2015 \u2014 NNT \u2248 8 to prevent one death) at the cost of a major bleeding risk of 10\u201320 per 1,000 (hemorrhagic stroke 1\u20133 per 1,000); in high-intermediate-risk PE (right ventricular dysfunction + elevated troponin) without shock \u2014 rescue thrombolysis: reserved for hemodynamic deterioration while on anticoagulation alone (PEITHO trial 2014 \u2014 reduction in early complications but excess hemorrhagic strokes with systematic thrombolysis); low-dose thrombolysis: alteplase 50 mg over 2 hours (MOPETT study 2013 \u2014 submassive PE \u2014 reduction in PAPS and HPEC at 28 months \u2014 limited data); the decision to perform thrombolysis in intermediate PE must be individualized \u2014 consultation between emergency physician, intensivist, and pulmonologist<\/td>\n <\/tr>\n <tr>\n <td>Surgical embolectomy and catheter-directed<br><small style=\"font-weight:400;color:#7a8fa0;\">Alternatives to systemic thrombolysis<\/small><\/td>\n <td>Surgical embolectomy under CPB: indicated if thrombolysis is contraindicated or has failed + massive PE with shock + thrombus in situ in the right heart + patent foramen ovale with paradoxical emboli \u2014 emergency cardiothoracic surgery + cardiopulmonary bypass (ECC) + pulmonary artery thrombus extraction \u2014 success rate 80\u201390% in expert centers \u2014 operative mortality 20\u201330% (versus >50% without treatment); catheter-directed thrombolysis (EKOS + CDT): multi-lumen catheter positioned in the pulmonary artery via a percutaneous approach (femoral vein \u2192 OD \u2192 PA) \u2014 local infusion of low-dose alteplase (1 mg\/h\/catheter \u00d7 12\u201324 h) \u00b1 low-frequency ultrasound (EKOS system \u2014 ULTIMA trial 2014 \u2014 SEATTLE II 2015 \u2014 reduction in mean PAP + improvement in RV\/LV ratio at 24 hours without excessive bleeding vs. systemic thrombolysis); catheter-directed thrombus aspiration (Penumbra Indigo, AngioVac): less well-evaluated option \u2014 specialized centers; caval filters (filter in the inferior vena cava): indicated if PE is confirmed + anticoagulation is strictly contraindicated (major active bleeding) or recurrence of PE despite optimal anticoagulation \u2014 retrievable filters preferred over permanent ones \u2014 removal as soon as anticoagulation is possible<\/td>\n <td>PERT (Pulmonary Embolism Response Teams) \u2014 interdisciplinary teams available in several university hospitals in Quebec (CHUM, MUHC, IUCPQ) \u2014 allow for rapid, collaborative decision-making (emergency physician + pulmonologist + hematologist + cardiologist + vascular surgeon) for high- and intermediate-high-risk PEs \u2014 their implementation is associated with reduced in-hospital mortality in several cohorts; permanent vena cava filters increase the long-term risk of DVT (Decousus PREPIC trial 1998) and are not a substitute for anticoagulation \u2014 their indication should be regularly reassessed with removal if possible; CPAP and non-invasive ventilation can worsen the hemodynamic status in massive PEs (increased RV afterload) \u2014 prioritize high-flow O\u2082 or orotracheal intubation with protective settings (avoid high pressures).<\/td>\n <\/tr>\n <tr>\n <td>Duration of anticoagulation and prevention of recurrence<br><small style=\"font-weight:400;color:#7a8fa0;\">Individualized decision \u2014 bleeding benefit\/risk balance<\/small><\/td>\n <td>Context-based decision algorithm: PE caused by a major transient surgical factor (surgery \u226530 min + general anesthesia + bed rest >3 days) \u2192 stop at 3 months \u2014 low risk of recurrence (3 % at 5 years); PE caused by a minor transient factor (travel, brief immobilization, contraceptives) \u2192 3 months \u2014 intermediate risk (15 % at 5 years); Unprovoked PE (idiopathic \u2014 no identified triggering factor) \u2192 minimum 3 months, followed by assessment of the benefit-risk ratio of prolongation \u2014 HERDOO2 score in women (hyperpigmentation + edema + lower limb erythema + post-anticoagulation D-dimers + obesity + age \u226565 years) \u2014 HAS-BLED score for bleeding risk \u2014 ESC recommendation: indefinite prolonged anticoagulation if low bleeding risk + first unprovoked episode + no contraindications; PE in active cancer \u2192 LMWH or apixaban\/rivaroxaban (CARAVAGGIO 2020 \u2014 HOKUSAI VTE Cancer) as long as cancer is active or being treated; major thrombophilia (antiphospholipid syndrome, antithrombin deficiency) \u2192 indefinite anticoagulation; recurrent PE \u2192 indefinite anticoagulation unless major bleeding risk<\/td>\n <td>Unprovoked PE recurs in 30\u201350% of cases at 10 years without prolonged anticoagulation\u2014the decision to discontinue anticoagulation at 3 months should be made in consultation with the patient (preferences + individual bleeding risk + quality of life on anticoagulation); reduced dose after 6 months: apixaban 2.5 mg twice daily (AMPLIFY-EXT trial \u2014 67% reduction in recurrences vs. placebo) or rivaroxaban 10 mg once daily (EINSTEIN CHOICE \u2014 74% reduction vs. aspirin) \u2014 options for indefinite continuation with lower bleeding risk; aspirin alone (100 mg \u00d7 1\/day) is insufficient to prevent PE recurrence (only a 30% reduction \u2014 ASPIRE\/WARFASA) vs. reduced-dose OAC \u2014 do not use aspirin as an alternative to anticoagulants; post-anticoagulation D-dimer testing (1 month after discontinuation): Positive D-dimer levels \u2192 doubled risk of recurrence \u2192 strong argument for extending anticoagulation (DOLORES\/PROLONG study)<\/td>\n <\/tr>\n <tr>\n <td>Outpatient management and post-embolic pulmonary hypertension<br><small style=\"font-weight:400;color:#7a8fa0;\">Low-risk EP \u2014 long-term sequelae<\/small><\/td>\n <td>Outpatient treatment or early discharge from the emergency department for low-risk cases: simplified PESI (Pulmonary Embolism Severity Index) score = 0 (age <80 years + no cancer + HR <110 + SVR \u2265100 + SpO\u2082 \u226590 % + no heart failure or COPD) \u2192 low-risk PE \u2192 outpatient treatment possible + ACOD immediately; Hestia criteria (12 exclusion criteria for outpatient treatment) \u2014 if all negative \u2192 discharge possible; 30-day recurrence and mortality rates for outpatient treatment of low-risk PE: <1\u20132% (Aujesky 2011 Lancet \u2014 non-inferior to hospitalization); chronic thromboembolic pulmonary hypertension (CTEPH): long-term sequela \u2014 organized thrombus + pulmonary vascular remodeling \u2192 progressive obstruction of the pulmonary arteries \u2192 pulmonary hypertension (mean PAP >25 mmHg on right heart catheterization) \u2014 incidence: 0.5\u20133.8 per 1,000 PE cases at 2 years; presentation: progressive exertional dyspnea + exercise intolerance + signs of chronic cor pulmonale; diagnosis: V\/Q scan (first step \u2014 high sensitivity) + CT angiography + pulmonary catheterization; standard surgical treatment: pulmonary endarterectomy (PEA) \u2014 Jamieson procedure \u2014 expert centers (Toronto General Hospital \u2014 top Canadian center) + riociguat (Adempas \u2014 soluble guanylate cyclase stimulator) if inoperable or residual HPTEC post-PEA<\/td>\n <td>HPTEC is underdiagnosed\u2014any patient with PE and persistent dyspnea lasting >3 months who is on optimal anticoagulation should undergo a screening V\/Q scan; PAH is curable in 70\u201380% of operable cases (normalization of pulmonary pressures)\u2014operative mortality is 2\u20135% in expert centers; riociguat (Adempas) is the only drug treatment approved by Health Canada for inoperable HPTEC\u2014reimbursed by RAMQ under certain conditions; cardiopulmonary rehabilitation after PE is recommended for patients with persistent deconditioning or CTEPH \u2014 improves functional capacity and quality of life; 6-minute walk test (6MWT) + echocardiography + NT-proBNP: follow-up evaluations at 3 and 6 months after PE to screen for CTEPH and assess RV recovery<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2139\ufe0f<\/span>\n <span><strong>Thrombophilia testing - when to prescribe it:<\/strong> A thrombophilia workup (Factor V Leiden, prothrombin G20210A mutation, protein C, protein S, antithrombin, antiphospholipid antibodies\u2014lupus anticoagulant + anticardiolipin IgG\/IgM + anti-beta2-GP1) is recommended in cases of unprovoked PE before age 50, a first-degree family history of VTE, recurrent PE or DVT, thrombosis in an unusual site (mesenteric, caval, cerebral veins), or suspected antiphospholipid syndrome. It should be performed at least 3 months after the acute event and at a distance from anticoagulation (warfarin falsely alters protein C and S levels; DOACs can interfere with some functional coagulation tests). A positive result modifies the duration of anticoagulation but should not delay treatment of the acute event.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Emergency \u2014 Massive pulmonary embolism and shock<\/div>\n <p>Dial <strong>911<\/strong> immediately if: <strong>Sudden severe shortness of breath + chest pain + SpO\u2082 <90% 1\u20133 minutes + tachycardia >120 bpm<\/strong> pulmonary embolism until proven otherwise \u2014 transfer to ER.<\/p>\n <p><strong>Hypotension (SBP < 90 mmHg) + syncope + signs of shock<\/strong> (pallor, mottling, altered consciousness) in this context \u2192 massive PE \u2192 emergency thrombolysis or surgical embolectomy for life-threatening condition \u2014 high-flow O\u2082 + IV access + call for resuscitation team.<\/p>\n <p><strong>Patient known for anticoagulation for PE with sudden respiratory worsening<\/strong> \u2192 Embolic recurrence or bleeding on anticoagulation - urgent evaluation.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Clinique Omicron physicians evaluate patients presenting with symptoms suggestive of pulmonary embolism (unexplained shortness of breath, chest pain, tachycardia), apply validated diagnostic algorithms (Wells score, D-dimers, CT angiography referral), initiate anticoagulation, and provide outpatient follow-up for low-risk PEs treated at home. Post-PE follow-up, including monitoring for CTEPH and optimal anticoagulation duration, is coordinated with the pulmonology and internal medicine teams. Consultations are available at our service points in Quebec and via telemedicine. To book an appointment, visit <a href=\"https:\/\/cliniqueomicron.ca\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">The content of this page is provided for informational purposes only and does not substitute for the advice of a qualified healthcare professional. Any suspicion of pulmonary embolism constitutes a medical emergency requiring immediate hospital evaluation.<\/p>\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron M\u00e9decine interne & Pneumologie & M\u00e9decine d’urgence Embolie pulmonaire L’embolie pulmonaire (EP) est une obstruction aigu\u00eb d’une ou plusieurs art\u00e8res pulmonaires par un mat\u00e9riel thrombotique \u2014 dans plus de 90 % des cas un thrombus provenant d’une thrombose veineuse profonde (TVP) des membres inf\u00e9rieurs ou… <a href=\"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Pulmonary Embolism: Symptoms, Diagnosis, and Treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron","_metasync_otto_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","_metasync_otto_og_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","_metasync_otto_twitter_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","_metasync_otto_twitter_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron","_aioseo_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charge au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-06-13T19:45:41+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-24534","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...\" \/>\n\t<meta name=\"robots\" content=\"max-snippet:1, max-image-preview:large, max-video-preview:1\" \/>\n\t<meta name=\"google-site-verification\" content=\"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM\" \/>\n\t<meta name=\"msvalidate.01\" content=\"3225E6935FC4F40C7DDCE56C37141BA8\" \/>\n\t<link rel=\"canonical\" href=\"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/\" \/>\n\t<meta name=\"generator\" content=\"All in One SEO Pro (AIOSEO) 4.9.8\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Clinique Omicron - Clinique M\u00e9dicale\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron\" \/>\n\t\t<meta property=\"og:description\" content=\"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...\" \/>\n\t\t<meta property=\"og:url\" content=\"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/\" \/>\n\t\t<meta property=\"og:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"og:image:secure_url\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<meta property=\"article:published_time\" content=\"2026-03-01T02:54:08+00:00\" \/>\n\t\t<meta property=\"article:modified_time\" content=\"2026-03-08T23:06:16+00:00\" \/>\n\t\t<meta property=\"article:publisher\" content=\"https:\/\/facebook.com\/Clinique Omicron\" \/>\n\t\t<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n\t\t<meta name=\"twitter:site\" content=\"@Clinique%20Omicron\" \/>\n\t\t<meta name=\"twitter:title\" content=\"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron\" \/>\n\t\t<meta name=\"twitter:description\" content=\"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...\" \/>\n\t\t<meta name=\"twitter:creator\" content=\"@Clinique%20Omicron\" \/>\n\t\t<meta name=\"twitter:image\" content=\"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg\" \/>\n\t\t<script type=\"application\/ld+json\" class=\"aioseo-schema\">\n\t\t\t{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#breadcrumblist\",\"itemListElement\":[{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\",\"nextItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#listItem\",\"name\":\"Embolie pulmonaire : sympt\\u00f4mes, diagnostic et traitement | Clinique Omicron\"}},{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#listItem\",\"position\":2,\"name\":\"Embolie pulmonaire : sympt\\u00f4mes, diagnostic et traitement | Clinique Omicron\",\"previousItem\":{\"@type\":\"ListItem\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en#listItem\",\"name\":\"Accueil\"}}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#webpage\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/\",\"name\":\"Embolie pulmonaire : sympt\\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron\",\"description\":\"L'embolie pulmonaire est une obstruction art\\u00e9rielle pulmonaire par un caillot sanguin. Sympt\\u00f4mes, score de Wells, D-dim\\u00e8res, anticoagulants et prise en charg...\",\"inLanguage\":\"en-CA\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\"},\"breadcrumb\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/embolie-pulmonaire\\\/#breadcrumblist\"},\"datePublished\":\"2026-02-28T22:54:08-04:00\",\"dateModified\":\"2026-03-08T19:06:16-04:00\"},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#website\",\"url\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/\",\"name\":\"Clinique Omicron\",\"description\":\"Clinique M\\u00e9dicale\",\"inLanguage\":\"en-CA\",\"publisher\":{\"@id\":\"https:\\\/\\\/cliniqueomicron.ca\\\/en\\\/#organization\"}}]}\n\t\t<\/script>\n\t\t\r\n\t\t<title>Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron<\/title>\n\n","aioseo_head_json":{"title":"Pulmonary Embolism: Symptoms, Diagnosis, and Treatment | Brossard | Omicron Clinic","description":"Pulmonary embolism is a pulmonary artery obstruction caused by a blood clot. Symptoms, Wells score, D-dimers, anticoagulants, and management...","canonical_url":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/","robots":"max-snippet:1, max-image-preview:large, max-video-preview:1","keywords":"","webmasterTools":{"google-site-verification":"yYDMZv-nme7Cg-KrW5GmEWceBTrCDv8zhSkkXdJSnyM","msvalidate.01":"3225E6935FC4F40C7DDCE56C37141BA8","miscellaneous":""},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"BreadcrumbList","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#breadcrumblist","itemListElement":[{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","position":1,"name":"Accueil","item":"https:\/\/cliniqueomicron.ca\/en","nextItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#listItem","name":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron"}},{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#listItem","position":2,"name":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron","previousItem":{"@type":"ListItem","@id":"https:\/\/cliniqueomicron.ca\/en#listItem","name":"Accueil"}}]},{"@type":"WebPage","@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#webpage","url":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/","name":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Brossard | Clinique Omicron","description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","inLanguage":"en-CA","isPartOf":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#website"},"breadcrumb":{"@id":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/#breadcrumblist"},"datePublished":"2026-02-28T22:54:08-04:00","dateModified":"2026-03-08T19:06:16-04:00"},{"@type":"WebSite","@id":"https:\/\/cliniqueomicron.ca\/en\/#website","url":"https:\/\/cliniqueomicron.ca\/en\/","name":"Clinique Omicron","description":"Clinique M\u00e9dicale","inLanguage":"en-CA","publisher":{"@id":"https:\/\/cliniqueomicron.ca\/en\/#organization"}}]},"og:locale":"en_US","og:site_name":"Clinique Omicron - Clinique M\u00e9dicale","og:type":"article","og:title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","og:description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","og:url":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/","og:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","og:image:secure_url":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg","article:published_time":"2026-03-01T02:54:08+00:00","article:modified_time":"2026-03-08T23:06:16+00:00","article:publisher":"https:\/\/facebook.com\/Clinique Omicron","twitter:card":"summary_large_image","twitter:site":"@Clinique%20Omicron","twitter:title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","twitter:description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","twitter:creator":"@Clinique%20Omicron","twitter:image":"https:\/\/cliniqueomicron.ca\/wp-content\/uploads\/2025\/12\/unnamed-1-e1765579964732.jpg"},"aioseo_meta_data":{"post_id":"24534","title":"Pulmonary Embolism: Symptoms, Diagnosis, and Treatment | Brossard | Omicron Clinic","description":"Pulmonary embolism is a pulmonary artery obstruction caused by a blood clot. Symptoms, Wells score, D-dimers, anticoagulants, and management...","keywords":null,"keyphrases":{"focus":{"keyphrase":"embolie","score":75,"analysis":{"keyphraseInTitle":{"score":9,"maxScore":9,"error":0},"keyphraseInDescription":{"score":9,"maxScore":9,"error":0},"keyphraseLength":{"score":9,"maxScore":9,"error":0,"length":1},"keyphraseInURL":{"score":5,"maxScore":5,"error":0},"keyphraseInIntroduction":{"score":9,"maxScore":9,"error":0},"keyphraseInSubHeadings":{"score":3,"maxScore":9,"error":1},"keyphraseInImageAlt":[],"keywordDensity":{"type":"high","score":0,"maxScore":9,"error":1}}},"additional":[]},"primary_term":null,"canonical_url":null,"og_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","og_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","og_object_type":"default","og_image_type":"default","og_image_url":null,"og_image_width":null,"og_image_height":null,"og_image_custom_url":null,"og_image_custom_fields":null,"og_video":"","og_custom_url":null,"og_article_section":null,"og_article_tags":null,"twitter_use_og":true,"twitter_card":"summary_large_image","twitter_image_type":"default","twitter_image_url":null,"twitter_image_custom_url":null,"twitter_image_custom_fields":null,"twitter_title":"Embolie pulmonaire : sympt\u00f4mes, | Brossard | Clinique Omicron","twitter_description":"L'embolie pulmonaire est une obstruction art\u00e9rielle pulmonaire par un caillot sanguin. Sympt\u00f4mes, score de Wells, D-dim\u00e8res, anticoagulants et prise en charg...","schema":{"blockGraphs":[],"customGraphs":[],"default":{"data":{"Article":[],"Course":[],"Dataset":[],"FAQPage":[],"Movie":[],"Person":[],"Product":[],"ProductReview":[],"Car":[],"Recipe":[],"Service":[],"SoftwareApplication":[],"WebPage":[]},"graphName":"WebPage","isEnabled":true},"graphs":[]},"schema_type":"default","schema_type_options":null,"pillar_content":false,"robots_default":false,"robots_noindex":false,"robots_noarchive":false,"robots_nosnippet":false,"robots_nofollow":false,"robots_noimageindex":false,"robots_noodp":false,"robots_notranslate":false,"robots_max_snippet":"1","robots_max_videopreview":"1","robots_max_imagepreview":"large","priority":null,"frequency":"default","local_seo":null,"seo_analyzer_scan_date":"2026-04-24 08:12:30","breadcrumb_settings":null,"limit_modified_date":false,"reviewed_by":null,"open_ai":null,"ai":{"faqs":[],"keyPoints":[],"titles":[],"descriptions":[],"socialPosts":{"email":[],"linkedin":[],"twitter":[],"facebook":[],"instagram":[]}},"created":"2026-03-01 03:25:32","updated":"2026-06-13 15:45:41"},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t<a href=\"https:\/\/cliniqueomicron.ca\/en\" title=\"Accueil\">Accueil<\/a>\n<\/span><span class=\"aioseo-breadcrumb-separator\">\u203a<\/span><span class=\"aioseo-breadcrumb\">\n\tEmbolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron\n<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Accueil","link":"https:\/\/cliniqueomicron.ca\/en"},{"label":"Embolie pulmonaire : sympt\u00f4mes, diagnostic et traitement | Clinique Omicron","link":"https:\/\/cliniqueomicron.ca\/en\/embolie-pulmonaire\/"}],"_links":{"self":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24534","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/comments?post=24534"}],"version-history":[{"count":4,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24534\/revisions"}],"predecessor-version":[{"id":28643,"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/pages\/24534\/revisions\/28643"}],"wp:attachment":[{"href":"https:\/\/cliniqueomicron.ca\/en\/wp-json\/wp\/v2\/media?parent=24534"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}