Pulmonary embolism

What you need to knowDiagnosis of pulmonary embolism (PE) is frequently missed. An estimated 12-36% of patients with PE are misdiagnosed during initial evaluation in emergency departments or primary care clinicsDelayed and missed diagnoses are more common in older adults, in patients with chronic cardiopulmonary disease, those with low pre-test risk of PE, and in patients presenting with cough or gradual onset dyspnoea. Most patients with PE have no symptoms of deep vein thrombosis, and many have no chest pain.Using D-dimer thresholds adjusted for age or probability may reduce false positive results and rates of computed tomography pulmonary angiography scans.A 71 year old woman with hypertension, coronary artery disease, and heart failure presents to her GP with fatigue and breathlessness at rest over the past 10 days. She reports a mild non-productive cough and occasional sore throat during this time, and says that deep breaths make her chest feel “heavy.”…
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