Pulmonary embolism laboratory findings
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Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], The APEX Trial Investigators; Associate Editor(s)-in-Chief:
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
D-dimer Test
- 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)
Routine Blood Tests
- Pulmonary embolism arterial blood gas analysis
- 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
Workup for Hypercoagulability
- 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