Symptomatology, Clinical Presentation and Basic Work up in Patients with Suspected Pulmonary Embolism

2016 ◽  
pp. 33-48 ◽  
Author(s):  
Poul Henning Madsen ◽  
Søren Hess
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Presentation ◽  
Suspected Pulmonary Embolism ◽  
Basic Work ◽  
Work Up

The Diagnostic Assessment of Suspected Pulmonary Embolism on the Acute Medical Take: An Evidence Based Guide

2007 ◽  
Vol 6 (1) ◽  
pp. 20-26
Author(s):  
Alastair Proudfoot ◽  
◽  
Derek Bell ◽  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Clinical Presentation ◽  
Diagnostic Assessment ◽  
Evidence Based ◽  
Suspected Pulmonary Embolism ◽  
The Subject ◽  
Adjusted Incidence ◽  
Age And Sex

Pulmonary Embolism is a common cardiopulmonary illness with an age and sex adjusted incidence of around 117 cases per 100 000 person years. The clinical presentation is extremely heterogeneous and non specific. Risk factors for venous thromboembolism are well established. When combined with presenting features and investigations. a multimodality algorithm has led to significant changes in the diagnostic approach of suspected PE. While the best combination of tests for any individual patient remains the subject of controversy this article aims to rationalise the acute physician’s approach to diagnosis and use of available investigations.

Impact of Delay in Clinical Presentation on the Diagnostic Management and Prognosis of Patients with Suspected Pulmonary Embolism

2013 ◽  
Vol 187 (12) ◽  
pp. 1369-1373 ◽  
Author(s):  
Paul L. den Exter ◽  
Josien van Es ◽  
Petra M. G. Erkens ◽  
Mark J. G. van Roosmalen ◽  
Pim van den Hoven ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Presentation ◽  
Suspected Pulmonary Embolism ◽  
Diagnostic Management

scholarly journals Clinical presentation and investigation of patients proceeding to isotope lung scanning for suspected pulmonary embolism.

1990 ◽  
Vol 66 (774) ◽  
pp. 285-289 ◽  
Author(s):  
A. G. Fennerty ◽  
H. G. Shetty ◽  
D. Paton ◽  
G. Roberts ◽  
P. A. Routledge ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Presentation ◽  
Suspected Pulmonary Embolism ◽  
Lung Scanning

scholarly journals Non-invasive diagnostic work-up of patients with clinically suspected pulmonary embolism; results of a management study

2004 ◽  
Vol 2 (7) ◽  
pp. 1110-1117 ◽  
Author(s):  
M. Ten Wolde ◽  
P. J. Hagen ◽  
M. R. Macgillavry ◽  
I. J. Pollen ◽  
A. T. A. Mairuhu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Suspected Pulmonary Embolism ◽  
Management Study ◽  
Non Invasive ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Clinical usefulness of D-dimer testing in cancer patients with suspected pulmonary embolism

2006 ◽  
Vol 95 (04) ◽  
pp. 715-719 ◽  
Author(s):  
Grégoire Le Gal ◽  
Sylvain De Lucia ◽  
Pierre-Marie Roy ◽  
Guy Meyer ◽  
Drahomir Aujesky ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cancer Patients ◽  
Diagnostic Value ◽  
Clinical Usefulness ◽  
Limited Data ◽  
Suspected Pulmonary Embolism ◽  
Diagnostic Work ◽  
Work Up ◽  
D Dimer ◽  
Rule Out

SummaryLimited data are available about the diagnostic value of D-dimer testing in cancer patients with clinically suspected pulmonary embolism (PE).Therefore, we evaluated i) the safety and clinical usefulness of an ELISA D-dimer test to rule out PE in cancer patients compared with non-cancer patients and ii) whether adopting a higher D-dimer cut-off value might increase the usefulness of D-dimer in cancer patients. We analysed data from two outcome studies which enrolled 1,721 consecutive patients presenting in the emergency department with clinically suspected PE. Presence of an active malignancy was abstracted from the database. All patients underwent a sequential diagnostic work-up including an ELISA D-dimer test and a 3-month followup. Sensitivity and predictive value (NPV) were 100% in both cancer and non-cancer patients. PE was ruled out by a negative D-dimer test in 494/1,554 (32%) patients without cancer, and in 18/164 (11%) patients witha malignancy. At cut-off values varying from 500 to 900 µg/l, the sensitivity was unchanged (100%, 95% CI: 93% to 100%) and the specificity increased from 16% (95% CI:11% to 24%) to 30% (95% CI:22% to 39%).The 3-month thromboembolic risk was 0% (95 % CI: 0% to 18%) in cancer patients witha negative D-dimer test. ELISA D-dimer appears safe to rule out pulmonary embolism in cancer patients but it is negative in only one of ten patients at the usual cut-off value. Increasing the cut-off value of D-dimer in cancer patients might increase the test’s clinical usefulness.

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