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Management of Acute Pulmonary Embolism pp 91–103Cite as

Contemporary Diagnostic Algorithm for the Hemodynamically Stable Patient With Suspected Pulmonary Embolism

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

No single diagnostic test has sufficient accuracy when used alone to confirm or rule out pulmonary embolism (PE). This even applies to pulmonary angiography, the historical gold standard in PE diagnosis. Therefore, modern diagnostic strategies for PE rely on combinations of noninvasive tests such as plasma D-dimer measurement, lower limb venous compression ultrasonography, ventilation-perfusion lung scan, and/or helical computed tomography, the results of which should be interpreted in the context of the clinical likelihood of PE. Pulmonary angiography is rarely necessary. Clinical probability of PE can be assessed with fair accuracy, either implicitly or by clinical prediction rules. Management studies, in which patients deemed not to have PE are left untreated and followed up to assess their 3-mo thromboembolic risk, have become the benchmark for validation of diagnostic algorithms. Cost-effectiveness analysis allows the evaluation and comparison of the various diagnostic sequences. The existing evidence shows that implementation of evidence-based diagnostic algorithms is feasible and may increase quality of care.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, Geneva University Hospital and Geneva Faculty of Medicine, Geneva, Switzerland

    Arnaud Perrier MD

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  1. Arnaud Perrier MD
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Editors and Affiliations

  1. Department of Cardiology and Pulmonology, Georg August University, Goettingen, Germany

    Stavros V. Konstantinides MD (Professor of Medicine) (Professor of Medicine)

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© 2007 Humana Press Inc., Totowa, NJ

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Perrier, A. (2007). Contemporary Diagnostic Algorithm for the Hemodynamically Stable Patient With Suspected Pulmonary Embolism. In: Konstantinides, S.V. (eds) Management of Acute Pulmonary Embolism. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-287-8_7

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  • DOI: https://doi.org/10.1007/978-1-59745-287-8_7

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-644-3

  • Online ISBN: 978-1-59745-287-8

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