Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation helical CT scan pulmonary angiogram VQ scan Treatment questions for doctor specialist Home Care warning signs Prevention Outlook Complications Underlying Cause Anatomy

PE Evaluation

The evaluation of a pulmonary embolism begins with a history and physical exam.

Physical findings in someone with a pulmonary embolism may include:

If deep venous thrombosis is present is the leg, there may be:

Tests that may be used to evaluate a pulmonary embolism include:

Tests that may be used to locate the source of the blood clot in someone with a pulmonary embolism include:

PE Helical CT Scan

A helical CT scan can detect a blockage in a pulmonary artery, caused by a pulmonary embolism. Helical CT offers the advantage of being less invasive than other diagnostic tests for pulmonary embolism.

During CT pulmonary angiography, an x-ray dye is injected into the bloodstream before the CT scan is performed. The dye outlines the blood flow through the arteries. The addition of dye slightly increases the risk, but can dramatically increase the accuracy in detecting pulmonary embolism.

PE Pulmonary Angiogram

Pulmonary angiography is considered to be the gold standard for the diagnosis of a pulmonary embolism.

During a pulmonary angiogram, dye is injected into the lung arteries, and the flow of dye through the arteries is viewed on x-ray. If a pulmonary embolism is present, it will appear as a blocked artery on the x-ray image.

PE VQ Scan

A nuclear scan of the lung, called a ventilation-perfusion scan (VQ scan), can detect most cases of pulmonary embolism.

This test offers the advantage of being less invasive than pulmonary angiography and thus, presents less risk for complications. In addition, a VQ scan exposes the body to much less radiation than a helical CT scan.

During VQ scanning, radioactive material is injected into the bloodstream and inhaled in a mixture of air. Afterward, images of the lungs are taken with a gamma camera.

Continue to PE Treatment

Last Updated: Jan 3, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed PE References
  1. Fedullo PF, Tapson VF. Clinical practice. The evaluation of suspected pulmonary embolism. N Engl J Med. 2003 Sep 25;349(13):1247-56. [14507950]
  2. Kruip MJ, Leclercq MG, van der Heul C, Prins MH, Buller HR. Diagnostic strategies for excluding pulmonary embolism in clinical outcome studies. A systematic review. Ann Intern Med. 2003 Jun 17;138(12):941-51. [12809450]
  3. Roberts KE, Hamele-Bena D, Saqi A, Stein CA, Cole RP. Pulmonary tumor embolism: a review of the literature. Am J Med. 2003 Aug 15;115(3):228-32. [12935829]
  4. Roy PM, Colombet I, Durieux P, Chatellier G, Sors H, Meyer G. Systematic review and meta-analysis of strategies for the diagnosis of suspected pulmonary embolism. BMJ. 2005 Jul 30;331(7511):259. [16052017]
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