Autopsies suggest that only 20% of pulmonary embolism cases are diagnosed when the patient is still alive. Due to the variety of signs and symptoms, each with varied intensity, this condition is often does undiagnosed or misdiagnosed. Usually, both the clinical finding and laboratory tests are not sufficient to make a definitive diagnosis.
The first step in diagnosis is to assess the state of the patient, check their vital signs, rule out other illnesses, and look for specific symptoms (enumerated below). The next step is to perform a D-dimer test and to evaluate the Pulmonary Embolism score, using the Geneva Score calculator (both full or simplified) or the Wells Rule.
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Patients in the "low risk" group do not have to undergo any further testing if they do not show any of the criteria listed below:
- Low oxygen saturation <95%;
- Age > 50;
- Hormone use;
- Prior Pulmonary Embolism (PE) or Deep Vein Thrombosis (DVT);
- Recent surgery or trauma;
- Rapid heart rate;
- Coughing up blood; or
- Unilateral leg swelling.
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If the Revised Geneva Score calculator indicates that Pulmonary Embolism may be the cause of the presenting symptoms, the physician may use one or more of the following techniques to confirm the diagnosis:
- Computer Tomography (CT) or Angio-CT;
- Magnetic Resonance Imagining (MRI);
- X-ray;
- Ultrasonography (US) and the compression test; or
- Echocardiography.
Don't hesitate to check our PERC calculator (Pulmonary Embolism Rule-Out Criteria)!