Skip to main content
SpringerLink
Log in

Symptomatology, Clinical Presentation and Basic Work up in Patients with Suspected Pulmonary Embolism

  • Chapter
  • First Online:
Thrombosis and Embolism: from Research to Clinical Practice

Part of the book series: Advances in Experimental Medicine and Biology ((AIM,volume 906))

Abstract

Basic knowledge of pulmonary embolism is relevant to most practicing physicians. Many medical specialties care for patients with increased risk of pulmonary embolism, why recognition of relevant symptoms, a thorough medical history, assessment of the clinical condition of the patient and possibly referral to a relevant facility should be a part of the skills of all clinicians. Sudden onset dyspnea, chest pain, syncope and hemoptysis are essential symptoms of pulmonary embolism, and in most of these patients basic investigations like arterial blood gas analysis, electrocardiogram, chest x-ray and biochemical analyses are appropriate. In addition, lung ultrasound and echocardiography are indicated in many of these patients. The information available from the medical history, clinical assessment and basic investigation form the basis on which the decision about further diagnostic imaging and intensity of treatment and monitoring can be made. These decisions can be guided by clinical scoring systems like the Wells score, revised Geneva score and the PESI.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ageno W, Becattini C, Brighton T, Selby R, Kamphuisen PW (2008) Cardiovascular risk factors and venous thromboembolism: a metaanalysis. Circulation 117:93–102

    Article  PubMed  Google Scholar 

  • Akpinar EE, HoÅŸgün D, Akpinar S, Ataç GK, DoÄŸanay B, Gülhan M (2014) Incidence of pulmonary embolism during COPD exacerbation. J Bras Pneumol 40(1):38–45

    Article  PubMed  PubMed Central  Google Scholar 

  • Anderson FA Jr, Spencer FA (2003) Risk factors for venous thromboembolism. Circulation 107(23 Suppl 1):I9–I16

    PubMed  Google Scholar 

  • Aujesky D, Obrosky DS, Stone RA, Auble TE, Perrier A, Cornuz J, Roy PM, Fine MJ (2005) Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 172(8):1041–1046

    Article  PubMed  PubMed Central  Google Scholar 

  • Aujesky D, Roy PM, Verschuren F, Righini M, Osterwalder J, Egloff M, Renaud B, Verhamme P, Stone RA, Legall C, Sanchez O, Pugh NA, N’gako A, Cornuz J, Hugli O, Beer HJ, Perrier A, Fine MJ, Yealy DM (2011) Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial. Lancet 378(9785):41–48

    Article  PubMed  Google Scholar 

  • Chan CM, Woods C, Shorr AF (2010) The validation and reproducibility of the pulmonary embolism severity index. J Thromb Haemost 8(7):1509–1514

    Article  CAS  PubMed  Google Scholar 

  • Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, Mottier D, Oger E, Samama MM, Spannagl M, VTE Impact Assessment Group in Europe (VITAE) (2007) Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 98(4):756–764

    CAS  PubMed  Google Scholar 

  • Comess KA, DeRook FA, Russell ML, Tognazzi-Evans TA, Beach KW (2000) The incidence of pulmonary embolism in unexplained sudden cardiac arrest with pulseless electrical activity. Am J Med 109(5):351–356

    Article  CAS  PubMed  Google Scholar 

  • Coutance G, Cauderlier E, Ehtisham J, Hamon M, Hamon M (2011) The prognostic value of markers of right ventricular dysfunction in pulmonary embolism: a meta-analysis. Crit Care 15(2):R103

    Article  PubMed  PubMed Central  Google Scholar 

  • Dixon J, Ahn E, Zhou L, Lim R, Simpson D, Merriman EG (2015) Venous thromboembolism rates in patients undergoing major hip and knee joint surgery at Waitemata District Health Board: a retrospective audit. Intern Med J 45(4):416–422

    Article  CAS  PubMed  Google Scholar 

  • Donadini MP, Dentali F, Squizzato A, Guasti L, Ageno W (2014) Unsuspected pulmonary embolism in cancer patients: a narrative review with pooled data. Intern Emerg Med 9(4):375–384

    Article  PubMed  Google Scholar 

  • Donze’ J, Le Gal G, Fine MJ, Roy PM, Sanchez O, Verschuren F, Cornuz J, Meyer G, Perrier A, Righini M, Aujesky D (2008) Prospective validation of the Pulmonary Embolism Severity Index. A clinical prognostic model for pulmonary embolism. Thromb Haemost 100(5):943–948

    Google Scholar 

  • Douma RA, Mos IC, Erkens PM, Nizet TA, Durian MF, Hovens MM, van Houten AA, Hofstee HM, Klok FA, ten Cate H, Ullmann EF, Bu¨ller HR, Kamphuisen PW, Huisman MV (2011) Performance of 4 clinical decision rules in the diagnostic management of acute pulmonary embolism: a prospective cohort study. Ann Intern Med 154(11):709–718

    Article  PubMed  Google Scholar 

  • Elliott CG, Goldhaber SZ, Visani L, DeRosa M (2000) Chest radiographs in acute pulmonary embolism. Results from the International Cooperative Pulmonary Embolism Registry. Chest 118(1):33–38

    Article  CAS  PubMed  Google Scholar 

  • Finfer SR, Vincent JL (2013) Circulatory shock. N Engl J Med 369:1726–1734

    Article  Google Scholar 

  • Garcia D, Ageno W, Libby E (2005) Update on the diagnosis and management of pulmonary embolism. Br J Haematol 131(3):301–312

    Article  CAS  PubMed  Google Scholar 

  • Geibel A, Zehender M, Kasper W, Olschewski M, Klima C, Konstantinides SV (2005) Prognostic value of the ECG on admission in patients with acute major pulmonary embolism. Eur Respir J 25(5):843–848

    Article  CAS  PubMed  Google Scholar 

  • Goldhaber SZ (2010) Risk factors for venous thromboembolism. J Am Coll Cardiol 56(1):1–7

    Article  PubMed  Google Scholar 

  • Guo DJ, Zhao C, Zou YD, Huang XH, Hu JM, Guo L (2015) Values of the Wells and revised Geneva scores combined with D-dimer in diagnosing elderly pulmonary embolism patients. Chin Med J (Engl) 128(8):1052–1057

    Article  Google Scholar 

  • Hamidi S, Riazi M (2015) Incidence of venous thromboembolic complications in instrumental spinal surgeries with preoperative chemoprophylaxis. J Korean Neurosurg Soc 57(2):114–118

    Article  PubMed  PubMed Central  Google Scholar 

  • Hardeman JA, van der Griend R, Koster T, Prins MH, Biesma DH (2010) Out of hospital treatment of acute pulmonary embolism in patients with a low NT-proBNP level. J Thromb Haemost 8(6):1235–1241

    Article  PubMed  Google Scholar 

  • Hariharan P, Dudzinski DM, Okechukwu I, Takayesu JK, Chang Y, Kabrhel C (2015) Association between electrocardiographic findings, right heart strain, and short-term adverse clinical events in patients with acute pulmonary embolism. Clin Cardiol 38(4):236–242

    Article  PubMed  Google Scholar 

  • Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJ 3rd (2005) Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med 143(10):697–706

    Article  PubMed  Google Scholar 

  • Henzler T, Roeger S, Meyer M, Schoepf UJ, Nance JW Jr, Haghi D, Kaminski WE, Neumaier M, Schoenberg SO, Fink C (2012) Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction. Eur Respir J 39(4):919–926

    Article  CAS  PubMed  Google Scholar 

  • Hsu WY, Lane HY, Lin CL, Kao CH (2015) A population-based cohort study on deep vein thrombosis and pulmonary embolism among schizophrenia patients. Schizophr Res 162(1–3):248–252

    Article  PubMed  Google Scholar 

  • Kabrhel C, McAfee AT, Goldhaber SZ (2006) The probability of pulmonary embolism is a function of the diagnoses considered most likely before testing. Acad Emerg Med 13:471–474

    Article  PubMed  Google Scholar 

  • Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PFA (2006) WHO analysis of causes of maternal death: a systematic review. Lancet 367:1066–1074

    Article  PubMed  Google Scholar 

  • Kim V, Goel N, Gangar J, Zhao H, Ciccolella DE, Silverman EK, Crapo JD, Criner GJ, The COPD Gene Investigators (2014) Risk factors for venous thromboembolism in chronic obstructive pulmonary disease. Chronic Obstr Pulm Dis (Miami) 1(2):239–249

    Article  Google Scholar 

  • Kline JA, Kabrhel C (2015a) Emergency evaluation for pulmonary embolism, Part 2: diagnostic approach. J Emerg Med 49(1):104–117. doi:10.1016/j.jemermed.2014.12.041

    Article  PubMed  Google Scholar 

  • Kline JA, Kabrhel C (2015b) Emergency evaluation for pulmonary embolism, Part 1: clinical factors that increase risk. J Emerg Med; pii: S0736-4679(14)01428-0. doi:10.1016/j.jemermed.2014.12.040. [Epub ahead of print]

    Google Scholar 

  • Kline JA, Nelson RD, Jackson RE et al (2002) Criteria for the safe use of D-dimer testing in emergency department patients with suspected pulmonary embolism: a multicenter United States study. Ann Emerg Med 39:144–152

    Article  PubMed  Google Scholar 

  • Kline JA, Mitchell AM, Kabrhel C et al (2004) Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost 2:1247–1255

    Article  CAS  PubMed  Google Scholar 

  • Klok FA, Mos IC, Huisman MV (2008) Brain-type natriuretic peptide levels in the prediction of adverse outcome in patients with pulmonary embolism: a systematic review and meta-analysis. Am J Respir Crit Care Med 178(4):425–430

    Article  PubMed  Google Scholar 

  • Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, Gibbs JS, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M, Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35(43):3033–3069

    Article  PubMed  Google Scholar 

  • Kreit JW (2004) The impact of right ventricular dysfunction on the prognosis and therapy of normotensive patients with pulmonary embolism. Chest 125(4):1539–1545

    Article  PubMed  Google Scholar 

  • Kukreja JE, Levey HR, Scosyrev E, Kiernan M, Berrondo C, McNamee C, Wu G, Joseph JV, Ghazi A, Rashid H, Dozier A, Messing EM (2015) Effectiveness and safety of extended-duration prophylaxis for venous thromboembolism in major urologic oncology surgery. Urol Oncol 33(9): 387.e7–16 pii: S1078-1439(14)00463-3. doi: 10.1016/j.urolonc.2014.12.010. [Epub ahead of print]

    Google Scholar 

  • LaMori JC, Shoheiber O, Mody SH, Bookhart BK (2015) Inpatient resource use and cost burden of deep vein thrombosis and pulmonary embolism in the United States. Clin Ther 37(1):62–70

    Article  PubMed  Google Scholar 

  • Lankeit M, Jiménez D, Kostrubiec M, Dellas C, Hasenfuss G, Pruszczyk P, Konstantinides S (2011) Predictive value of the high-sensitivity troponin T assay and the simplified Pulmonary Embolism Severity Index in hemodynamically stable patients with acute pulmonary embolism: a prospective validation study. Circulation 124(24):2716–2724

    Article  CAS  PubMed  Google Scholar 

  • Laursen CB, Sloth E, Lassen AT, Christensen RD, Lambrechtsen J, Madsen PH, Henriksen DP, Davidsen JR, Rasmussen F (2014) Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial. Lancet Respir Med 2(8):638–646

    Article  PubMed  Google Scholar 

  • Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H (2006) Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 144:165–71

    Article  PubMed  Google Scholar 

  • Lesser BA, Leeper KV Jr, Stein PD, Saltzman HA, Chen J, Thompson BT, Hales CA, Popovich J Jr, Greenspan RH, Weg JG (1992) The diagnosis of acute pulmonary embolism in patients with chronic obstructive pulmonary disease. Chest 102(1):17–22

    Article  CAS  PubMed  Google Scholar 

  • Lichte P, Kobbe P, Almahmoud K, Pfeifer R, Andruszkow H, Hildebrand F, Lefering R, Pape HC, Trauma Register DGU (2015) Post-traumatic thrombo-embolic complications in polytrauma patients. Int Orthop 39(5):947–954

    Article  PubMed  Google Scholar 

  • Logan JK, Pantle H, Huiras P, Bessman E, Bright L (2014) Evidence-based diagnosis and thrombolytic treatment of cardiac arrest or periarrest due to suspected pulmonary embolism. Am J Emerg Med 32(7):789–796

    Article  PubMed  Google Scholar 

  • Madsen PH, Hess S, Madsen HD (2010) A case of unexplained hypoxemia. Respir Care 57(11):1469–1470

    Google Scholar 

  • Manning HL, Schwartzstein RM (1995) Pathophysiology of dyspnea. N Engl J Med 333(23):1547–1553

    Article  CAS  PubMed  Google Scholar 

  • Meng K, Hu X, Peng X, Zhang Z (2015) Incidence of venous thromboembolism during pregnancy and the puerperium: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 28(3):245–253

    Article  CAS  PubMed  Google Scholar 

  • Miniati M, Prediletto R, Formichi B, Marini C, Di Ricco G, Tonelli L et al (1999) Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 159:864–871

    Article  CAS  PubMed  Google Scholar 

  • Miniati M, Monto S, Bottai M (2003) A structured clinical model for predicting the probability of pulmonary embolism. Am J Med 114(3):173–179

    Article  PubMed  Google Scholar 

  • Miniati M, Bottai M, Monti S et al (2008) Simple and accurate prediction of the clinical probability of pulmonary embolism. Am J Respir Crit Care Med 178:290–294

    Article  PubMed  Google Scholar 

  • Miniati M, Cenci C, Monti S, Poli D (2012) Clinical presentation of acute pulmonary embolism: survey of 800 cases. PLoS One 7:e30891

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Neuberger F, Wennike N (2013) Problem based review: pulmonary embolism in pregnancy. Acute Med 12(4):239–245

    CAS  PubMed  Google Scholar 

  • Ng KJ, Lee YK, Huang MY, Hsu CY, Su YC (2015) Risks of venous thromboembolism in patients with liver cirrhosis: a nationwide cohort study in Taiwan. J Thromb Haemost 13(2):206–213

    Article  PubMed  Google Scholar 

  • O’Connor C, Moriarty J, Walsh J, Murray J, Coulter-Smith S, Boyd W (2011) The application of a clinical risk stratification score may reduce unnecessary investigations for pulmonary embolism in pregnancy. J Matern Fetal Neonatal Med 24(12):1461–1464

    Article  PubMed  Google Scholar 

  • Park SJ, Kim CK, Park YS, Moon YW, Lim SJ, Kim SM (2015) Incidence and factors predicting venous thromboembolism after surgical treatment of fractures below the hip. J Orthop Trauma 29(10):e349–354. doi:10.1097/BOT.0000000000000336

    Google Scholar 

  • Patocka C, Nemeth J (2012) Pulmonary embolism in pediatrics. J Emerg Med 42(1):105–116

    Article  PubMed  Google Scholar 

  • Perelas A, Dimou A, Saenz A, Rhee JH, Teerapuncharoen K, Rowden A, Eiger G (2015) Incidental findings on computed tomography angiography in patients evaluated for pulmonary embolism. Ann Am Thorac Soc 12(5):689–695

    Article  PubMed  Google Scholar 

  • Perrier A, Roy PM, Aujesky D et al (2004) Diagnosing pulmonary embolism in outpatients with clinical assessment, D-dimer measurement, venous ultrasound, and helical computed tomography: a multicenter management study. Am J Med 116:291–299

    Article  PubMed  Google Scholar 

  • Piazza G (2015) Beyond Virchow’s Triad: does cardiovascular inflammation explain the recurrent nature of venous thromboembolism? Vasc Med 20(2):102–104

    Article  PubMed  Google Scholar 

  • Pollack CV, Schreiber D, Goldhaber SZ, Slattery D, Fanikos J, O’Neil BJ, Thompson JR, Hiestand B, Briese BA, Pendleton RC, Miller CD, Kline JA (2011) Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry). J Am Coll Cardiol 57(6):700–706

    Article  PubMed  Google Scholar 

  • Ray P, Birolleau S, Lefort Y et al (2006) Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis. Crit Care 10:R82

    Article  PubMed  PubMed Central  Google Scholar 

  • Rizkallah J, Man SF, Sin DD (2009) Prevalence of pulmonary embolism in acute exacerbations of COPD: a systematic review and metanalysis. Chest 135(3):786–793

    Article  PubMed  Google Scholar 

  • Rodger MA, Carrier M, Jones GN, Rasuli P, Raymond F, Djunaedi H, Wells PS (2000) Diagnostic value of arterial blood gas measurement in suspected pulmonary embolism. Am J Respir Crit Care Med 162(6):2105–2108

    Article  CAS  PubMed  Google Scholar 

  • Sharma GV, Sasahara AA, McIntyre KM (1976) Pulmonary embolism: the great imitator. Dis Mon 22(7):4–38

    Article  CAS  PubMed  Google Scholar 

  • Shteinberg M, Segal-Trabelsy M, Adir Y, Laor A, Vardi M, Bitterman H (2012) Clinical characteristics and outcomes of patients with clinically unsuspected pulmonary embolism versus patients with clinically suspected pulmonary embolism. Respiration 84(6):492–500

    Article  PubMed  Google Scholar 

  • Simpson EL, Lawrenson RA, Nightingale AL, Farmer RD (2001) Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG 108(1):56–60

    CAS  PubMed  Google Scholar 

  • Squizzato A, Donadini MP, Galli L, Dentali F, Aujesky D, Ageno W (2012) Prognostic clinical prediction rules to identify a low-risk pulmonary embolism: a systematic review and meta-analysis. J Thromb Haemost 10(7):1276–1290

    Article  CAS  PubMed  Google Scholar 

  • Squizzato A, Rancan E, Dentali F, Bonzini M, Guasti L, Steidl L, Mathis G, Ageno W (2013) Diagnostic accuracy of lung ultrasound for pulmonary embolism: a systematic review and meta-analysis. J Thromb Haemost 11(7):1269–1278

    Article  CAS  PubMed  Google Scholar 

  • Stein PD, Dalen JE, McIntyre KM, Sasahara AA, Wenger NK, Willis PW 3rd (1975) The electrocardiogram in acute pulmonary embolism. Prog Cardiovasc Dis 17(4):247–257

    Google Scholar 

  • Stein PD, Henry JW (1997) Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes. Chest 112(4):974–979

    Article  CAS  PubMed  Google Scholar 

  • Stein PD, Saltzman HA, Weg JG (1991a) Clinical characteristics of patients with acute pulmonary embolism. Am J Cardiol 68:1723–1724

    Article  CAS  PubMed  Google Scholar 

  • Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT, Weg JG (1991b) Clinical, laboratory, roentgenographic and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 100:598–603

    Article  CAS  PubMed  Google Scholar 

  • Stein PD, Afzal A, Henry JW et al (2000) Fever in acute pulmonary embolism. Chest 117:39–42

    Article  CAS  PubMed  Google Scholar 

  • Stein PD, Hull RD, Patel KC, Olson RE, Ghali WA, Brant R, Biel RK, Bharadia V, Kalra NK (2004) D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med 140(8):589–602

    Article  PubMed  Google Scholar 

  • Tamaki H, Khasnis A (2015) Venous thromboembolism in systemic autoimmune diseases: a narrative review with emphasis on primary systemic vasculitides. Vasc Med. doi:1358863X15573838

    Google Scholar 

  • The PEITHO Steering Committee (2012) Single-bolus tenecteplase plus heparin compared with heparin alone for normotensive patients with acute pulmonary embolism who have evidence of right ventricular dysfunction and myocardial injury: rationale and design of the Pulmonary Embolism Thrombolysis (PEITHO) trial. Am Heart J 163(1):33–38

    Article  Google Scholar 

  • Touw HR, Tuinman PR, Gelissen HP, Lust E, Elbers PW (2015) Lung ultrasound: routine practice for the next generation of internists. Neth J Med 73(3):100–107

    CAS  PubMed  Google Scholar 

  • van Belle A, Büller HR, Huisman MV, Huisman PM, Kaasjager K, Kamphuisen PW, Kramer MH, Kruip MJ, Kwakkel-van Erp JM, Leebeek FW, Nijkeuter M, Prins MH, Sohne M, Tick LW, Christopher Study Investigators (2006) Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 295(2):172–179

    Article  PubMed  Google Scholar 

  • Vuilleumier N, Le Gal G, Verschuren F, Perrier A, Bounameaux H, Turck N, Sanchez JC, Mensi N, Perneger T, Hochstrasser D, Righini M (2009) Cardiac biomarkers for risk stratification in non-massive pulmonary embolism: a multicenter prospective study. J Thromb Haemost 7(3):391–398

    Article  CAS  PubMed  Google Scholar 

  • Wahlsten LR, Eckardt H, Lyngbæk S, Jensen PF, Fosbøl EL, Torp-Pedersen C, Gislason GH, Olesen JB (2015) Symptomatic venous thromboembolism following fractures distal to the knee: a nationwide danish cohort study. J Bone Joint Surg Am 97(6):470–477

    Article  PubMed  Google Scholar 

  • Wells PS, Anderson DR, Rodger M, Ginsberg JS, Kearon C, Gent M, Turpie AG, Bormanis J, Weitz J, Chamberlain M, Bowie D, Barnes D, Hirsh J (2000) Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 83(3):416–20

    CAS  PubMed  Google Scholar 

  • White RH (2003) The epidemiology of venous thromboembolism. Circulation 107(23 Suppl 1):I4–I8

    PubMed  Google Scholar 

  • Wicki J, Perneger TV, Junod AF, Bounameaux H, Perrier A (2001) Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med 161:92–97

    Article  CAS  PubMed  Google Scholar 

  • Wolberg AS, Aleman MM, Leiderman K, Machlus KR (2012) Procoagulant activity in hemostasis and thrombosis: Virchow’s Triad revisited. Anesth Analg 114(2):275–285

    Article  CAS  PubMed  Google Scholar 

  • Wolf SJ, McCubbin TR, Feldhaus KM, Faragher JP, Adcock DM (2004) Prospective validation of Wells Criteria in the evaluation of patients with suspected pulmonary embolism. Ann Emerg Med 44(5):503–510

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Respiratory Medicine, Vejle Hospital, Vejle, Denmark

    Poul Henning Madsen M.D.

  2. Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark

    Søren Hess M.D.

  3. Department of Radiology and Nuclear Medicine, Hospital of Southwest Jutland, Esbjerg, Denmark

    Søren Hess M.D.

Authors
  1. Poul Henning Madsen M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Søren Hess M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Søren Hess M.D. .

Editor information

Editors and Affiliations

  1. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden

    Md. Shahidul Islam

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Madsen, P.H., Hess, S. (2016). Symptomatology, Clinical Presentation and Basic Work up in Patients with Suspected Pulmonary Embolism. In: Islam, M. (eds) Thrombosis and Embolism: from Research to Clinical Practice. Advances in Experimental Medicine and Biology(), vol 906. Springer, Cham. https://doi.org/10.1007/5584_2016_104

Download citation

  • DOI: https://doi.org/10.1007/5584_2016_104

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22107-6

  • Online ISBN: 978-3-319-22108-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation