[Acute massive pulmonary embolism].

To establish the diagnosis of the acute massive pulmonary embolism is critically urgent for the doctors, because the life saving causal therapy should be introduced as soon as possible. The combined use of the estimated clinical probability and the results of one or more noninvasive examinations increase the accuracy in confirming the diagnosis of embolism. The most important methods to confirm or rule out the suspicion of pulmonary embolism are the noninvasive perfusion pulmonary isotopic scanning, spiral CT, echocardiography and the invasive "gold standard" pulmonary angiography. The life saving causal therapy means the urgent recanalization of the obstructed pulmonary arteries. The surgical embolectomy is a high risk intervention, but the invasive radiological methods are also capable of destroying the emboli mechanically and very effectively. The different thrombolytic treatment methods mean causal therapy too, and these protocols can be used in every hospital. There is no alternative treatment in patients with sudden clinical death caused by acute pulmonary embolism: the drug administration during reanimation should be completed with thrombolysis.