Acute pulmonary embolism. Part 1: epidemiology and diagnosis.

Nature Reviews. Cardiology
R A DoumaHarry R Büller

Abstract

Pulmonary embolism (PE) is a frequently occurring, acute, and potentially fatal condition. Numerous risk factors for PE, both inherited and acquired, have been identified. Adequate diagnosis is mandatory to prevent PE-related morbidity and mortality on the one hand, and unnecessary treatment on the other. Only around 1 in 5 individuals with suspected PE will have the diagnosis confirmed, therefore, the diagnostic work-up for PE should comprise safe, efficient, and noninvasive methods. The first step in the approach to diagnosis of patients with suspected PE is to determine the clinical probability and to perform a D-dimer test. PE can be excluded in patients with a 'low', 'intermediate' or 'unlikely' clinical probability and a normal D-dimer test. Additional imaging is required for those with a 'high' or 'likely' clinical probability or a positive D-dimer test. CT pulmonary angiography or ventilation-perfusion scintigraphy, followed by additional testing is the next step when test results are nondiagnostic. Although various diagnostic strategies have been introduced and validated, selected patients may require a tailored approach.

References

May 17, 1992·The New England Journal of Medicine·J L CarsonT E Hobbins
Jul 1, 1991·Chest·W C MillerD M Suich
Oct 15, 1987·The New England Journal of Medicine·J MiletichG Broze
Jan 1, 1986·Respiration; International Review of Thoracic Diseases·S PetruzzelliC Giuntini
Oct 28, 1995·Lancet·D C ReesJ B Clegg
May 1, 1994·British Journal of Haematology·R C TaitR W Carrell
Jan 1, 1994·Journal of Thoracic Imaging·N SchlugerD Hayt
Feb 18, 1998·JAMA : the Journal of the American Medical Association·J D DouketisJ S Ginsberg
Jan 29, 1999·Lancet·A PerrierH Bounameaux
Feb 16, 1999·Lancet·A W LensingH R Büller
Mar 2, 1999·American Journal of Respiratory and Critical Care Medicine·M MiniatiM Pistolesi
Apr 21, 1999·Lancet·F R Rosendaal
Oct 8, 1999·Obstetrics and Gynecology·P LindqvistK Marŝál
Jun 29, 2000·JAMA : the Journal of the American Medical Association·T G McGinnW S Richardson
Jun 29, 2000·QJM : Monthly Journal of the Association of Physicians·A BerghoutH R Büller
Jan 9, 2001·Archives of Internal Medicine·J WickiA Perrier
Nov 28, 2001·British Journal of Haematology·P ChablozP de Moerloose
Feb 13, 2003·Circulation·H Richard Hellstrom
May 31, 2003·Thorax·UNKNOWN British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group
Jun 20, 2003·Circulation·Richard H White
Jul 16, 2003·Epidemiology·Torben Bjerregaard LarsenKaare Christensen
Sep 6, 2003·Thrombosis and Haemostasis·Richard H WhitePatrick S Romano
Jul 21, 2004·The Journal of Emergency Medicine·Peter B RichmanMark Mandell
Aug 12, 2004·Journal of Thrombosis and Haemostasis : JTH·G Le Gal, H Bounameaux
Oct 1, 2004·Journal of Thrombosis and Haemostasis : JTH·M NijkeuterM V Huisman
Dec 24, 2004·European Heart Journal·Cecilia BecattiniFranco Casazza
Feb 11, 2005·JAMA : the Journal of the American Medical Association·Jeanet W BlomFrits R Rosendaal
Apr 29, 2005·The New England Journal of Medicine·Arnaud PerrierHenri Bounameaux

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Citations

Oct 19, 2013·Current Hypertension Reports·Jinghui LiYingsheng Cheng
Mar 13, 2012·European Heart Journal·Emanuela R Valsangiacomo Buechel, Luc L Mertens
Nov 17, 2012·Clinical Nuclear Medicine·Søren HessAbass Alavi
Sep 11, 2012·Best Practice & Research. Clinical Haematology·Rupert M Bauersachs
May 6, 2015·The American Journal of Emergency Medicine·Libing JiangYuefeng Ma
May 8, 2015·Current Treatment Options in Cardiovascular Medicine·Nosheen Reza, David M Dudzinski
May 7, 2016·Journal of Translational Medicine·Thorsten KesslerHendrik B Sager
Dec 21, 2013·Multidisciplinary Respiratory Medicine·Federico LavoriniMassimo Pistolesi
Aug 24, 2017·Future Cardiology·Roberta EspositoMaurizio Galderisi
May 19, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kenneth E RemyCameron Dezfulian
Sep 16, 2010·Nature Reviews. Cardiology·Josien van EsHarry R Büller
May 14, 2021·Lancet·Faizan KhanMarc A Rodger

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