Long-term course and recovery following pulmonary embolism

Pulmonary embolism (PE) poses a considerable burden regarding mortality and sequelae. Up to 50% of patients develop long-term functional impairment with varying degrees of severity. This may be caused by persistent changes in pulmonary artery flow, pulmonary gas exchange, and/or cardiac function. Consequently, patients may report symptoms such as shortness of breath, reduced exercise tolerance, or deconditioning months to years after the event. Another important component of the so-called post-PE syndrome are psychosocial complications such as depression and anxiety, ultimately resulting in a decrease in quality of life. Even though these sequelae have been recognized and follow-up strategies have been proposed, the understanding of the development of PE-related symptoms and strategies to prevent sequelae remain limited. In this Journal of Thrombosis and Haemostasis in Clinic review, we demonstrate the course of recovery after acute PE, describe determinants of poor recovery, and discuss interventions to improve long-term outcomes.