Chronic pulmonary emboli are mainly a consequence of incomplete resolution of acute pulmonary thromboembolism. Clinically symptoms and signs may be preceded by Acute PE for more than two weeks

Pharmacological

Long-term oral anticoagulation

• Warfarin 2–10mg once a day orally

Maintain INR 2.0–3.0

OR

• S: Rivaroxaban 15–20 mg PO every 24 hours

Referral: All cases suspected of pulmonary embolus should be referred to a high level of care

IVC filter: useful to prevent PE in patients who cannot be anticoagulated, but it raises the risk of DVT and long-term complications; the benefit is greatest early after placement, and the filter should be removed when no longer needed.