Pulmonary Embolism (cont.)

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Basic testing

Basic testing may include:

The chest X-ray is often normal in pulmonary embolism. The EKG may be usually normal, but may demonstrate a rapid heart rate, a sinus tachycardia (heart rate > 100 bpm). If there is significant blockage in a pulmonary artery, it acts like a dam and it is harder for the right side of the heart to push blood past the obstructing clot or clots. The EKG can demonstrate a right heart strain.

Since the cost of missing the diagnosis of pulmonary embolus can be death, the health care professional has to consider the diagnosis when caring for a patient complaining of chest pain or shortness of breath.

Pulmonary angiogram

In the past, the gold standard for the diagnosis of pulmonary embolus is a pulmonary angiogram in which a catheter is threaded into the pulmonary arteries, usually from veins in the leg. Dye is injected and a clot or clots can be identified on imaging studies. This is considered an invasive test and is rarely performed.

Fortunately, there are other, less invasive ways to make the diagnosis. The decision as to which test might best make the diagnosis needs to be individualized to the patient and their presentation and situation.

Medically Reviewed by a Doctor on 6/30/2014

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