Pulmonary embolism diagnostic approach
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The diagnostic approach to pulmonary embolism requires the initial assessment of the pretest probability of the disease according to the modified Wells score.
Diagnosis Algorithm
| Assess the pretest probability of PE 'using the modified Wells criteria | |||||||||||||||||||||||||||||||||
| Low pretest probability of PE | High pretest probability of PE | ||||||||||||||||||||||||||||||||
| Order D-dimer | |||||||||||||||||||||||||||||||||
| Normal D-dimer (<500 ng/ml) | Elevated D-dimer (>500 ng/ml) | Order CT pulmonary angiography | |||||||||||||||||||||||||||||||
| PE is excluded | Negative | Positive | |||||||||||||||||||||||||||||||
| PE is excluded | PE is confirmed | ||||||||||||||||||||||||||||||||