Abstract
Like deep vein thrombosis (DVT), a high clinical suspicion is required, especially in patients with venous thromboembolism (VTE) risk factors, to make a timely diagnosis of pulmonary embolism (PE). Diagnosis of acute PE is often challenging because the disease presents as a variety of clinical syndromes, ranging from pleuritic pain to cardiac arrest. A diagnostic algorithm that integrates an assessment of clinical probability with appropriate laboratory testing and imaging modalities is critical. Contrast-enhanced chest computed tomogram (CT) is the predominant imaging test used to diagnosis PE.
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References
Dunn KL, Wolf JP, Dorfman DM, Fitzpatrick P, Baker JL, Goldhaber SZ. Normal D-dimer levels in emergency department patients suspected of acute pulmonary embolism. J Am Coll Cardiol. 2002;40:1475–8.
Stein PD, Hull RD, Patel KC, et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med. 2004;140:589–602.
Hunsaker AR, Lu MT, Goldhaber SZ, Rybicki FJ. Imaging in acute pulmonary embolism with special clinical scenarios. Circ Cardiovasc Imaging. 2010;3:491–500.
Quiroz R, Kucher N, Zou KH, et al. Clinical validity of a negative computed tomography scan in patients with suspected pulmonary embolism: a systematic review. JAMA. 2005;293:2012–7.
Stein PD, Chenevert TL, Fowler SE, et al. Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III). Ann Intern Med. 2010;152:434–43.
Piazza G. Submassive pulmonary embolism. JAMA. 2013;309:171–80.
Piazza G, Goldhaber SZ. Management of submassive pulmonary embolism. Circulation. 2010;122:1124–9.
McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol. 1996;78:469–73.
Pruszczyk P, Goliszek S, Lichodziejewska B, et al. Prognostic value of echocardiography in normotensive patients with acute pulmonary embolism. JACC Cardiovasc Imaging. 2014;7:553–60.
Piazza G, Goldhaber SZ. Fibrinolysis for acute pulmonary embolism. Vasc Med. 2010;15:419–28.
Piazza G, Goldhaber SZ. The acutely decompensated right ventricle: pathways for diagnosis and management. Chest. 2005;128:1836–52.
Goldhaber SZ. Echocardiography in the management of pulmonary embolism. Ann Intern Med. 2002;136:691–700.
van Belle A, Buller HR, Huisman MV, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA. 2006;295:172–9.
Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354:2317–27.
Perrier A, Bounameaux H. Accuracy or outcome in suspected pulmonary embolism. N Engl J Med. 2006;354:2383–5.
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Piazza, G., Hohlfelder, B., Goldhaber, S.Z. (2015). Diagnosis of Pulmonary Embolism: An Integrated Approach to Clinical Evaluation, Laboratory Testing, and Imaging. In: Handbook for Venous Thromboembolism. Springer, Cham. https://doi.org/10.1007/978-3-319-20843-5_5
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DOI: https://doi.org/10.1007/978-3-319-20843-5_5
Publisher Name: Springer, Cham
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