Diagnosis of pulmonary embolism

Presse Med. 2015 Dec;44(12 Pt 2):e385-91. doi: 10.1016/j.lpm.2015.10.007. Epub 2015 Nov 14.

Abstract

Pulmonary embolism is the third cause of mortality by cardiovascular disease after coronary artery disease and stroke, and its incidence is around 1/1000 per year. During the last two decades, many different non-invasive diagnostic tests have been developed and validated. For hemodynamically stable outpatients, the diagnosis of acute pulmonary embolism mainly rests on the sequential use of clinical assessment, D-dimer measurement and multidetector CT. In patients with a contraindication to CT, lower limb venous ultrasonography and ventilation-perfusion scintigraphy remain valid options. Massive pulmonary embolism is a distinct clinical entity with a specific diagnostic approach. In unstable patients with suspected pulmonary embolism, echocardiography should be the initial test.

Publication types

  • Review

MeSH terms

  • Echocardiography / methods
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Multidetector Computed Tomography / methods
  • Protein Multimerization
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / diagnostic imaging
  • Radionuclide Imaging
  • Venous Thrombosis / diagnostic imaging
  • Ventilation-Perfusion Ratio

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D