pulmonary embolism

Risk factors for pulmonary embolism (PE) include:

venous stasis
intimal injury (trauma, phlebitis)
Hypercoaguable states

Physical findings, EKG changes and blood-gas values are suggestive of PE, but are not specific. Thus, radiologic examinations play an important role in establishing the diagnosis.

The diagnostic work-up includes:

chest xray
- findings are usually nonspecific
- other abnormalities may reduce V/Q scans diagnostic value
pulmonary ventilation and perfusion ("V/Q") scan

contrast enhanced CT of the chest
- spiral or helical thin cuts during a contrast bolus timed for maximal pulmonary artery oppacification
possibly pulmonary angiogram
doppler ultrasound of the deep venous system
- symptoms of DVT
- very sugestive history with a negative work up

Charles E. Kahn, Jr., MD - 2 February 1995
Last updated: 1 September 2006