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Clinical investigations from the RACP

Investigating patients for pulmonary embolism

Paul J Torzillo

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Abstract

A diagnosis of pulmonary embolism can rarely be made on the basis of clinical assessment alone. The various tests available for diagnosing the condition and assessing its severity are reviewed here, with the conclusion that, despite the introduction of new technologies, the tests all have shortcomings.

Key Points

  • Pulmonary embolism is a major cause of hospital morbidity and mortality.
  • The diagnosis cannot be made by clinical features alone.
  • Understanding the utility of the different investigations is critical to management.
  • Physical examination and simple tests are important for assessing severity and for diagnosing other disorders.
  • CT pulmonary angiography is replacing V/Q scanning as the investigation of choice in patients with an abnormal chest x-ray.

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