Acute pulmonary embolism (acPE), limited to the first 48 hours of the disease, is a very dangerous situation with considerable mortality, often as a result of misdiagnosis. It is therefore necessary to establish the diagnosis and to begin therapy in the shortest possible time. The fastest and most reliable methods are the echocardiogram and helical (spiral) computed tomography, combined with plasma D-dimer measurement. With this approach, diagnostic accuracy is approximately 95%, and pulmonary artery angiography can be avoided in most cases.
A positive result from lower limb venous compression ultrasonography is useful for the diagnosis, especially in subacute pulmonary embolism (subacPE), with symptoms lasting for > 48 hours. Lung scan is only diagnostic in approximately 50% of cases, but is helpful for the diagnosis of subsegmental embolization. On one hand, the electrocardiogram (ECG) is unreliable for the diagnosis of acPE; on the other hand, it may represent the first indication of right ventricular (RV) overload.
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© 2009 Springer-Verlag London Limited
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(2009). Pulmonary Embolism. In: The ECG Manual. Springer, London. https://doi.org/10.1007/978-1-84800-171-8_8
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DOI: https://doi.org/10.1007/978-1-84800-171-8_8
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