Pulmonary Embolism (cont.)

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Basic testing (CBC, electrolytes, BUN, creatinine blood test, chest X-ray, EKG)

Basic testing in the diagnosis of pulmonary embolism 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 right heart muscle strain.

Since the risk of missing the diagnosis of pulmonary embolus can include death, the healthcare professional has to consider this diagnosis when caring for any patient complaining of chest pain or shortness of breath.

Pulmonary angiogram

In the past, the gold standard for the diagnosis of pulmonary embolus was a pulmonary angiogram, where a catheter was threaded into the pulmonary arteries, usually from veins in the leg. Dye was injected and a clot or clots could be identified on imaging studies. This is considered an invasive test and is now 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 11/20/2015

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