Establish a pretest probability based on clinical criteria.
Wells score
Clinical signs and symptoms of DVT +3
Alternative diagnosis is less likely than PE +3.
Heart rate >100 +1.5
Immobilizati...
Low risk PE → use anticoagulation or inferior vena cava (IVC) filter.
Submassive PE → anticoagulation + possible INR-guided thrombolysis
Massive PE →...
Provoked PE (trigger no longer present): 3 months
Unprovoked PE: >3 months; consider long-term or prolonged secondary prophylaxis if bleeding risk is low . H...
I26.99 Other pulmonary embolism without acute cor pulmonale
I27.82 Chronic pulmonary embolism
59282003 Pulmonary embolism (disorder)
133971000119108 chronic pulmonary embolism (disorder)
...
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FIGURE 1.3. Ventilation-perfusion imaging in diagnosis of pulmonary embolism. A:Ventilation image, obtained with 99mTc pentetate aerosol, shows homogenous ventilation on posterior view. B: Matched perfusion image shows large (segmental) perfusion defects in the left mid lung, and in the lateral segment of the left lower lobe. There is also decreased perfusion in the right upper lobe. The presence of unmatched segmental abnormalities indicates a high probability for pulmonary embolism.
FIGURE 1.3. Ventilation-perfusion imaging in diagnosis of pulmonary embolism. A:Ventilation image, obtained with 99mTc pentetate aerosol, ...
FIGURE 36.2. Bilateral pulmonary embolism (arrows) demonstrated by contrast-enhanced spiral computed tomography scan.
<bold>Figure 13.5</bold> Contrast enhanced multirow (16-slice) detector chest CT in a patient with acute pulmonary embolism. In the coronal reconstructed view, multiple segmental emboli can be visualized <italic>(arrows)</bold>. (Figure kindly provided by Joseph Schoepf, MD, Department of Radiology, Brigham and Womens Hospital, Boston, MA.)
<bold>Figure 13.5</bold> Contrast enhanced multirow (16-slice) detector chest CT in a patient with acute pulmonary embolism. I...
<bold>Figure 13.7</bold> Primary evidence of acute pulmonary embolism. Selective cut-film angiogram of the right lower lobe pulmonary artery with multiple intraluminal radiolucencies, almost completely outlined by contrast <bold>(left)</bold>. Corresponding segmental perfusion defects of the right lower lobe <bold>(right)</bold>.
<bold>Figure 13.7</bold> Primary evidence of acute pulmonary embolism. Selective cut-film angiogram of the right lower lobe pu...
Echocardiography in a patient with massive pulmonary embolism. The right ventricle (RV) is markedly enlarged, flattening the intraventricular septum and compromising the left ventricle (LV).
Echocardiography in a patient with massive pulmonary embolism. The right ventricle (RV) is markedly enlarged, flattening the intraventricu...
<bold>Figure 1.25. Ventilation-perfusion scan in a patient with pulmonary emboli. A.</bold> Perfusion scan of the lungs shows many areas devoid of radioisotope (photopenia) bilaterally. <bold>B.</bold> The ventilation scan is normal. This combination of findings is diagnostic of pulmonary embolism.
<bold>Figure 1.25. Ventilation-perfusion scan in a patient with pulmonary emboli. A.</bold> Perfusion scan of the lungs shows ...
<bold>Fig C 1-22 Pulmonary infarction.</bold> (A) Chest film made 3 days after open-heart surgery demonstrates a very irregular opacity at the right base (pneumonia versus pulmonary embolization with infarction). (B) On a film made 5 days later, the consolidation is seen to have reduced in size yet to have retained the same general configuration as on the initial view. The diagnosis of pulmonary embolism was confirmed by a radionuclide lung scan.<sup>5</sup>
<bold>Fig C 1-22 Pulmonary infarction.</bold> (A) Chest film made 3 days after open-heart surgery demonstrates a very irregula...