Pulmonary embolism: A diagnostic approach

Annals of Thoracic Medicine

Volumn 1, Issue 1, 2006, Pages 31-40

  Abdelaziz, Muntasir ^a   Wali, Siraj ^a   Hamad, Mahir ^b   Krayem, Ayman ^a   Samman, Yaseen ^a  

^a KING SAUD BIN ABDULAZIZ UNIVERSITY FOR HEALTH SCIENCES   (Saudi Arabia)

^b JAMES COOK UNIVERSITY HOSPITAL   (United Kingdom)

Author keywords

CT scan; D dimer; Pulmonary embolism; Ultrasound of the leg; VQ scan

Indexed keywords

EID: 33747736139     PISSN: 18171737     EISSN: None     Source Type: Journal    
DOI: 10.4103/1817-1737.25869     Document Type: Review

References (80)

1. Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog Cardiovasc Dis 1975;17:259-70.
2. Hyers TH. Venous thromboembolism. Am J Respir Crit Care Med 1999;159:1-14.
3. Pengo V, Lensing AW, Prins MH, Marchiori A Davidson BL, Tiozzo F, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Eng J Med. 2004;350:2257-64.
4. Goldhaber SZ. Pulmonary embolism. Lancet 2004;363:1295-305.
5. Silverstein MD, Herit JA, Mohr DN, Petterson TM, O' Fallon WM, Melton LJ 3rd. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population based study. Arch Intern Med 1998;158:585-93.
6. Rubinstein I, Murray D, Hoffstein V. Fatal pulmonary emboli in hospitalized patients. An autopsy study. Arch Intern Med 1988;148:1425-6.
7. Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and autopsy. Chest 1995;108:978-81.
8. van Beek EJ, Brouwerst EM, Song B, Stein PD, Oudkerk M. Clinical validity of a normal pulmonary angiogram in patients with suspected pulmonary embolism - a critical review. Clin Radiol 2001;56:838-42.
9. ATS Board of Directors, February 1999: Published by The American Thoracic Society. Am J Respir Crit Care Med 1999;160:1043-66.
10. British Thoracic Society: Suspected acute pulmonary embolism: a practical approach. Thorax 1997;52:S1-24.
11. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism: A practical approach. Thorax 2003;58:470-84.
12. A collaborative Study by the PIOPED investigators. Value of ventilation/perfusion scan in acute pulmonary embolism - results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA 1990;263:2753-9.
13. Hyers TM. Diagnosis of pulmonary embolism. Thorax 1995;50:930-2.
14. Fennerty AG, Shetty HG, Paton D, Robert G, Routledge PA, Campbell IA. Clinical Presentation and investigation of patients proceeding to Isotope lung scanning for suspected PE. Postgrad Med J 1999;66:285-9.
15. Wells PS, Ginsberg JS, Anderson DR, Kearon C, Gent M, Turpie AG, et al. Use of clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998;129:997-1005.
16. Miniati M, Prediletto R, Formichi B, Marini C, Di Ricco G, Tonelli L, et al. Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 1999;159:864-71.
17. Wicki J, Perneger TV, Junod AF, Bounameaux H, Perrier A. Assessing the clinical probability of pulmonary embolism in the emergency ward: A simple score. Arch Intern Med 2001;161:92-7.
18. Chagnon I, Bounameaux H, Aujesky D, Roy PM, Gourdier AL, Cornuz J, et al. Comparison of two clinical prediction rules and implicit assessment among patients with suspected pulmonary embolism. Am J Med 2002;113:269-75.
19. Musset D, Parent F, Meyer G, Maitre S, Girard P, Leroyer C, et al. Diagnostic strategy for patients with suspected pulmonary embolism: A prospective multi centre outcome study. Lancet 2002;360:1914-20.
20. Rosen M, Sands D, Morris J, Drake W, Davis RB. Does a physician's ability to accurately assess the likelihood of pulmonary embolism increase with training? Acad Med 2000;75:1199-205.
21. Wells PS, Ginsberg JS, Anderson DR, Kearon C, Gent M, Turpie AG, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998;129:997-1005.
22. Wells PS, Anderson DR, Rodger M, Stiell I, Dreyer JF, Barnes D, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: Management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D-dimer. Ann Intern Med 2001;135:98-107
23. Wells PS, Anderson DR, Rodger M, Ginsberg JS, Kearon C, Gent M, et al. Derivation of a simple clinical model to categorize patient probability of pulmonary embolism: Increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 2000;83:416-420.
24. Davies CW, Bell D, Wimperis J, Green S, Pendry K. Validation of pretest probability (PTP) scored to predict pulmonary embolism in routine practice. Thorax 2003;58:S82-3.
25. Dalen JE, Master MP. Pulmonary embolism: What have we learned since Virchow? Chest 2002;122:1440-56.
26. Green RM, Meyer TJ, Dunn M, Glassroth J. Pulmonary embolism in younger adults. Chest 1992;101:1507-11.
27. Stein PD, Goldhaber SZ, Henry JW, Miller AC. Arterial blood gas analysis in the assessment of suspected acute pulmonary embolism. Chest 1996;109:78-81.
28. Rodger MA, Carrier M, Jones GN, Rasuli P, Raymond F, Djunaedi H, et al. Diagnostic value of arterial blood gas measurement in suspected pulmonary embolism. Am J Respir Crit Care Med 2000;162:2105-8.
29. Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT, et al. Clinical, laboratory, roentgenographic and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 1991;100:598-603.
30. Szucs MM Jr, Brooks HL, Grossman W, Banas JS Jr, Meister G, Dexter L, et al. Diagnostic sensitivity of laboratory findings in acute pulmonary embolism. Ann Intern Med 1971;74:161-6.
31. Whitaker AN, Elms MJ, Massci PP, Bundesen PG, Rylatt DB, Webber AJ, et al. Measurement of cross-linked fibrin derivatives in plasma: An immunoassay using monoclonal antibodies. J Clin Pathol 1984;37:882-7.
32. Hirsh J, Lee AY. How we diagnose and treat deep venous thrombosis. Blood 2002;99:3102-10.
33. Sadosty AT, Goyal DG, Boie ET, Chiu CK. Emergency department D-dimer testing. J Emerg Med 2001;21:423-9.
34. Bounameaux H, Cirafici P, de Moerloose P, Schneider PA, Slosman D, Reber G, et al. Measurement of D-dimer in plasma as diagnostic aid in suspected pulmonary embolism. Lancet 1991;337:196-200.
35. Becker DM, Philbrick JT, Bachhuber TL, Humphries JE. D-dimer testing and acute venous thromboembolism: A shortcut to accurate diagnosis? Arch Intern Med 1996;156:939-49.
36. Moser KM. Diagnosing pulmonary embolism. Br Med J 1994;309:1525-6.
37. Ginsberg JS, Brill-Edwards PA, Demers C, Donovan D, Panju A. D-dimer in patients with clinically suspected pulmonary embolism. Chest 1993;104:1679-84.
38. de Moerloose P, Minazio P, Reber G, Perrier A, Bounameaux H. D-dimer determination to exclude pulmonary embolism: A two step approach using latex assay as a screening tool. Thromb Haemost 1994;72:89-91.
39. Farrell S, Hayes T, Shaw M. A negative SimpliRED D-dimer assay result does not exclude the diagnosis of deep vein thrombosis or pulmonary embolus in emergency department patients. Ann Emerg Med 2000;35:121-5.
40. Ginsberg JS, Wells PS, Kearon C, Anderson D, Crowther M, Weitz JI, et al. Sensitivity and specificity of a rapid whole-blood assay for D-dimer in the diagnosis of pulmonary embolism. Ann Intern Med 1998;129:1006-11.
41. Heit JA, Minor TA, Andrews JC, Larson DR, Li H, Nichols WL. Determination of plasma fibrin D-dimer sensitivity for acute pulmonary embolism as defined by pulmonary angiography. Arch Pathol Lab Med 1999;123:235-40.
42. Goldhaber SZ, Simons GR, Elliot CG, Haire WD, Toltzis R, Blacklow SC, et al. Quantitative D-dimer levels among patients undergoing pulmonary angiography for suspected pulmonary embolism. JAMA 1993;270:2819-22.
43. Perrier A, Desmarais S, Miron MJ, de Moerloose P, Lepage R, Slosman D, et al. Non-invasive investigation of VTE in outpatients. Lancet 1999;353:190-5.
44. Stein PD, Hull RD, Patel KC, Olson RE, Ghali WA, Brant R, et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism. Ann Intern Med 2004;140:589-602.
45. Perrier A, Roy PM, Sanchez O, Le Gal G, Meyer G, Gourdier AL, et al. Multidetector-row computed tomography in suspected pulmonary embolism. N Eng J Med 2005;352:1812-4.
46. Bates SM, Grand Maison A, Johnston M, Naguit I, Kovacs MJ, Ginsberg JS, et al. A latex D-dimer reliably excludes venous thromboembolism. Arch Intern Med 2001;161:447-53.
47. Heijboer H, Buller HR, Lensing AW, Turpie AG, Colly LP, ten Cate JW. A comparison of real-time compression ultrasonography with impedance plethysmography for the diagnosis of deep-vein thrombosis in symptomatic outpatients. N Engl J Med 1993;329:1365-9.
48. Birdwell BG, Raskob TL, Whitsett TL, Durica SS, Comp PC, George JN, et al. The clinical validity of normal compression ultrasonography in outpatients suspected of deep venous thrombosis. Ann Intern Med 1998;128:1-7.
49. Cogo A, Lensing AW, Koopman MM, Piovella F, Siragusa S, Wells PS, et al. Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study. BMJ 1998;316:17-20.
50. Elias A, Mallard L, Elias M, Alquier C, Guidolin F, Gauthier B, et al. A single complete ultrasound investigation of the venous network for the diagnostic management of patients with a clinically suspected first episode of deep venous thrombosis of the lower limbs. Thromb Haemost 2003;289;221-7.
51. Turkstra F, Kuijer PM, van Beck EJ, Brandijes DP, ten Cate JW, Buller HR. Diagnostic utility of ultrasonography of leg veins in patients suspected of having pulmonary embolism. Ann Intern Med 1997;126:775-81.
52. Davidson BL. Controversies in pulmonary embolism and deep venous thrombosis. Am Fam Physic 1999;60:1969-80.
53. Daniel KR, Jackson RE, Kline JA. Utility of lower extremity venous ultrasound scanning in the diagnosis and exclusion of pulmonary embolism in outpatients. Ann Emerg Med 2000;35:547-54.
54. Meyerovitz MF, Manning F, Polak JF, Goldhaber SZ. Frequency of pulmonary embolism in patients with low probability lung scan and negative lower extremity venous ultrasound. Chest 1999;115:980-2.
55. Perrier A, Miron MJ, Desmarais S, de Moerloose P, Slosman D, Didier D, et al. Using clinical evaluation and lung scan to rule out suspected pulmonary embolism: Is it a valid option in patients with normal results of lower-limb venous compression ultrasonography? Arch Intern Med 2000;160:512-6.
56. Hull RD, Raskob GE, Ginsberg JS, Panju AA, Brill-Edwards P, Coates G, et al. A non invasive strategy for the treatment of patients with suspected pulmonary embolism. Arch Intern Med 1994;154:289-97.
57. Bendick PJ, Glover JL, Brown OW, Ranaval TJ. Serial duplex ultrasound examinations for deep vein thrombosis in patients with suspected pulmonary embolism. J Vasc Surg 1996;24:732-7.
58. Cuteo SM, Cavanaugh SH, Benenson RS, Redclift MS. Computed tomography scan versus ventilation-perfusion lung scan in the detection of pulmonary embolism. J Emerg Med 2001;21:155-64.
59. Bankier AA, Janata K, Fleischmann D, Kreuzer S, Mallek R, Frossard M, et al. Severity assessment of acute pulmonary with spiral CT: evaluation of two modified angiographic scores and comparison with clinical data. J Thorac Imaging 1997;12:150-8.
60. Srivastava SD, Eagleton MJ, Greenfield LJ. Diagnosis of pulmonary embolism with various imaging modalities. Semin Vasc Surg 2004;17:173-80.
61. Kline JA, John KL, Colucciello SA, Israel EG. New diagnostic tests for pulmonary embolism. Ann Emerg Med 2000;35:168-80.
62. Rathbun SW, Raskob GE, Whitsett TL. Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: A systematic review. Ann Intern Med 2000;132:227-32.
63. Qanadli SD, Hajjam ME, Mesurolle B et al. Pulmonary embolism detection: Prospective evaluation of dual-section helical CT versus selective pulmonary arteriography in 157 patients. Radiology 2000;217:447-55.
64. Perrier A, Howarth N, Didier D, Loubeyre P, Unger PF, de Moerloose P, et al. Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism. Ann Int Mede 2001;135:88-97.
65. van Strijen MJ, de Monye W, Schiereck J, Kieft GJ, Prins MH, Huisman MV, et al. Single-detector helical computed tomography as the primary diagnostic test in suspected pulmonary embolism: A multicenter clinical management study of 510 patients. Ann Intern Med 2003;138:307-14.
66. Gottschalk A, Stein PD, Goodman LR, Sostman HD. Overview of prospective investigation of pulmonary embolism diagnosis II. Semi Nucl Med 2002;32:173-82.
67. Raptopoulos V, Boiselle PM. Multi-detector row spiral CT pulmonary angiography: Comparison with single-detector row spiral CT. Radiology 2001;221:606-13.
68. Patel S, Kazerooni EA, Casade PN. Pulmonary embolism: optimization of small pulmonary artery visualization at multi-detector row CT scan. Radiology 2003;227:455-60.
69. Prologo JD, Gilkeson RC, Diaz M, Cummings M. The effect of single-detector CT versus MDCT on clinical outcomes in patients with suspected acute pulmonary embolism and negative results on CT pulmonary angiography. AJR Am J Roentgenol 2005;184:1231-5.
70. Dalen JE, Brooks HL, Johnnson LW, Meister SG, Szucs MM Jr, Dexter L. Pulmonary angiography in acute pulmonary embolism: Indications, techniques and results in 367 patients. Am Heart J 1971;81:175-85.
71. Mills SR, Jackson DC, Older RA, Heaston DK, Moore AV. The incidence, etiologies and avoidance of complications of pulmonary angiography in a large series. Radiology 1980;136:295-9.
72. Gibson NS, Sohne M, Buller HR. Prognostic value of echocardiography and spiral computed tomography in patients with pulmonary embolism. Curr Opin Pulm Med 2005;11:380.
73. Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Prognostic role of echocardiography among patients with acute pulmonary embolism and a systolic arterial pressure of 90 mm Hg or higher. Arch Intern Med 2005;165:1777.
74. Come PC. Echocardiographic evaluation of pulmonary embolism and its response to therapeutic interventions. Chest 1992;101:151S.
75. Grifoni S, Olivotto I, Cecchini P, Pieralli F, Camaiti A, Santoro G, et al. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure and echocardiographic right ventricular dysfunction. Circulation 2000;101:2817.
76. McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol 1996;78:469-73.
77. Pruszczyk P, Torbicki A, Pacho R, Chlebus M, Kuch-Wocial A, Pruszynski B, et al. Noninvasive diagnosis of suspected severe pulmonary embolism: transesophageal echocardiography versus spiral CT. Chest 1997;112:722-8.
78. Goldhaber SZ, Haire WD, Feldstein ML, Miller M, Toltzis R, Smith JL, et al. Alteplase versus heparin in acute pulmonary embolism: randomized trial assessing right ventricular function and pulmonary perfusion. Lancet 1993;341:507-11.
79. Kasper W, Meinertz T, Henkel B, Eissner D, Hahn K, Hofmann T, et al. Echocardiographic findings in patients with proved pulmonary embolism. Am Heart J 1986;112:1284-90.
80. Wilson HT, Meagher TM, Williams SJ. Combined Helical Computed Tomographic pulmonary angiography and lung perfusion scintigraphy for investigating acute pulmonary embolism. Clin Radiol 2002;57:33-6.