There is a marked discrepancy between the incidence of PE which is clinically diagnosed (1%) and autopsy findings in hospitalised patients (65%). This review highlights the improvements that have occurred in clinical care. Less than 30% of the PE is diagnosed on the index visit in the elderly. Restricted activity as in prolonged flights and prolonged rest or immobilisation and surgery pose enormous risk for developing deep vein thrombosis. In the elderly the diagnosis is often missed because of the non-specific and atypical presentation. The diagnosis of PE in the elderly is difficult because of the presence of cardiopulmonary comorbidities, and furthermore the characteristics of diagnostic tests for PE may be altered by age. A non-invasive diagnosis strategy combines clinical assessment, D-dimer estimation, ultrasonography and helical CT which yielded a diagnosis in 99% of outpatients suspected of PE.
KeywordsPulmonary embolism Deep vein thrombosis D-dimer estimation Helical CT Computed tomography pulmonary angiography
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