High-Altitude Pulmonary Embolism: Epidemiology, Pathophysiology, Diagnosis, and Management.

Pulmonary embolism (PE) at high altitude (HA) is a potentially life-threatening but underrecognized condition. Unlike low-altitude PE, high-altitude pulmonary embolism (HA-PE) may result from unique hypoxia-driven mechanisms, including hemoconcentration, endothelial dysfunction, and a hypercoagulable state. In this narrative review, we summarize current evidence on the epidemiology, pathophysiology, diagnosis, management, and prognosis of HA-PE, based on the literature published between 2010 and 2025 retrieved from PubMed and CNKI. This review summarizes the epidemiological profile, clinical features, altitude-related diagnostic challenges, limitations of current therapeutic strategies, and the prognosis of HA-PE. A more comprehensive understanding of HA-PE is crucial for enhancing early detection and developing altitude-adapted management approaches.