[Usefulness of basic tests in patients with pulmonary embolism].
There are common, specific noninvasive and invasive tests for the diagnosis of pulmonary embolism (PE). Arterial blood gases, lung radiography and electrocardiography belong to the first group and should be performed in patients with suspected PE. Among the second group, D-dimer determination is essential. Ventilation-perfusion scintigraphy was formerly the most frequently used test but has been relegated to a second-line position by the development of multislice computed tomography (CT) angiography, which provides the possibility of simultaneously studying the lower limbs to detect deep venous thrombosis (DVT). SPECT and magnetic resonance imaging can be used as an alternative to multislice CT angiography, but there is less experience with these techniques. Transthoracic echocardiography has, above all, predictive value and lower limb ultrasonography is the most common non-invasive method to detect DVT. Invasive tests, the gold standard, are often unavailable and their use is therefore limited to selected patients. In conclusion, noninvasive management (clinical probability, D-dimer and multislice CT) is feasible in most patients with suspected PE.
Nauffal
Dolores
D
Servicio de Neumología, Hospital Universitario La Fe, Valencia, España. dneuffal@separ.es
Chacón
Liliana
L
Domènech
Rosalía
R
D000792:Angiography; D015901:Angiography, Digital Subtraction; D004562:Electrocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005240:Feasibility Studies; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D010690:Phlebography; D011237:Predictive Value of Tests; D011336:Probability; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging; D014692:Ventilation-Perfusion Ratio
D005338:Fibrin Fibrinogen Degradation Products