Clinical Correlations in the Diagnosis of Pulmonary Embolism

Abstract

Patients (73) with the clinical diagnosis of thromboembolism were studied; pulse rate, respiratory rate and PaCO2 [arterial partial pressure of CO2] have discriminatory value in identifying the group of acutely ill patients who are most likely to have pulmonary embolism. The clinical diagnosis of deep venous thrombosis, PaO2 [arterial partial pressure of O2], chest radiography and ECG, essential to patient management, have no such value. Only 29% of the patients had a pulmonary arteriogram positive for thromboembolism but the mortality rate in this group was 33%. Pulmonary perfusion scanning was a useful and accurate screening investigation and should be routinely employed prior to pulmonary angiography if the patient is stable hemodynamically.