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

Physical findings in someone with a pulmonary embolism may include:

• Abnormal heart sounds:
• During examination with a stethoscope
• Abnormal lung sounds:
• During examination with a stethoscope
• Cyanosis:
• Blue lips or nailbeds
• Fever
• Usually low grade
• Rapid heart rate
• Rapid respiratory rate

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

• Calf tenderness
• Leg swelling (unilateral)
• Calf swelling (unilateral)

Tests that may be used to evaluate pulmonary embolism include:

• Coagulation profile
• D-dimer
• Arterial blood gas analysis
• Chest x-ray
• Normal chest x-ray
• Fluid under one lung
• Electrocardiogram
• Pulse oximetry or arterial blood gases:
• Measures the oxygen level in the bloodstream
• CT scanning of the chest
• CT angiography of the chest
• Echocardiography
• MRI scan of the chest
• Pulmonary angiogram
• Ventilation-perfusion scan of the lungs

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

• Ultrasound of the legs
• Angiodynography
• Duplex ultrasound:
• MRI scanning of the pelvis:
• Detects clots that form in the pelvis
• Venogram
• Impedance plethysmography
• Radiolabeled fibrinogen:
• A nuclear scan