Abstract
Venous thromboembolism is a common disease which remains underdiagnosed because of nonspecific presentations which can range from asymptomatic incidental imaging findings to sudden death. Symptoms can overlap with comorbid cardiopulmonary disease, and risk factors that offer clues to the clinician are not always present. The diagnostic approach can vary depending on the specific clinical presentation, but ruling in the diagnosis nearly always depends on lung imaging. Overuse of diagnostic testing is another recognized problem; a cautious, evidence-based approach is required, although physician gestalt must be acknowledged. The following review offers an approach to the diagnosis of acute pulmonary embolism based on the assessment of symptoms, signs, risk factors, laboratory findings, and imaging studies.
Highlights
Venous thromboembolism (VTE), which includes the spectrum of deep venous thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular diagnosis following myocardial infarction and stroke
While the diagnostic evaluation is intimately associated with risk stratification, which may impact on the level of therapeutic aggressiveness, we will focus on the diagnostic approach to acute PE
Diagnostic approach Clinical probability models The combination of symptoms and clinical findings with the presence of predisposing factors for VTE allows the classification of patients with suspected PE into different categories of pre-test probability, which correspond to an increasing prevalence of confirmed PE
Summary
F1000 Faculty Reviews are written by members of the prestigious F1000 Faculty. They are commissioned and are peer reviewed before publication to ensure that the final, published version is comprehensive and accessible. The reviewers who approved the final version are listed with their names and affiliations. Any comments on the article can be found at the end of the article
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