Pulmonary embolism laboratory findings
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Pulmonary Embolism Microchapters |
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Diagnosis |
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Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores |
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Treatment |
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Follow-Up |
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Special Scenario |
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Trials |
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Case Studies |
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Pulmonary embolism laboratory findings On the Web |
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Directions to Hospitals Treating Pulmonary embolism laboratory findings |
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Risk calculators and risk factors for Pulmonary embolism laboratory findings |
Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], The APEX Trial Investigators; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
The results of routine laboratory tests including arterial blood gas analysis are non-specific in making the diagnosis of pulmonary embolism. These laboratory studies can be obtained to rule-out other cause of chest discomfort and tachypnea. In patients with acute pulmonary embolism, non-specific lab findings include: leukocytosis, elevated ESR with an elevated serum LDH and serum transaminase (especially AST or SGOT). A negative D-dimer in a patient with low to intermediate probability of pulmonary embolism strongly suggests pulmonary embolism is not present.
Laboratory Findings
Laboratory studies that are frequently ordered in the assessment of pulmonary embolism include the following:
- Arterial blood gas
- Plasma D-dimer
- Plasma D-dimer>500 ng/ml, PE present (Found to be 97% sensitive and 45% specific)
- Plasma D-dimer<500 excludes PE (Have a high negative predictive value)
- Workup for hypercoagulation: which include
- Activated protein C resistance
- Factor V Leiden mutation
- Protein C
- protein S, free and total.
- Antithrombin
- Lupus anticoagulant
- Anticardiolipin antibodies
- Plasma homocysteine values
- In patients with acute pulmonary embolism, routine laboratory findings are non-specific and include:
- Leukocytosis
- Elevated ESR with an elevated serum LDH and serum transaminase (especially AST or SGOT).
- Serum bilirubin levels are found to be within normal limits.
- In patients with suspected pulmonary embolism, routine laboratory tests are ordered to exclude the secondary causes of PE. These tests include:
- Complete blood count
- Erythrocyte sedimentation rate
- Coagulation studies to assess for hypercoagulable states.
- Other screening tests such as renal function tests, liver function tests and electrolyte assessment.