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Pulmonary Embolism Diagnosis

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1. Diagnosis and Management of Acute Pulmonary Embolism

Diagnosis and Management of Acute Pulmonary Embolism 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) | European Heart Journal | Oxford Academic ') We use cookies to enhance your experience on our website.By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Search Account Menu Menu Navbar Search Filter Mobile Microsite (...) Search Term Close search filter search input Article Navigation Close mobile search navigation Article Navigation Article Contents Article Navigation 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC) Stavros V Konstantinides Chairperson Germany/Greece Corresponding authors: Stavros

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2019 European Society of Cardiology

2. A novel electrocardiographic parameter for diagnosis of acute pulmonary embolism: RS time: RS time in acute pulmonary embolism

A novel electrocardiographic parameter for diagnosis of acute pulmonary embolism: RS time: RS time in acute pulmonary embolism Pulmonary embolism (PE) is one of the leading causes of cardiovascular mortality worldwide. Electrocardiography (ECG) may provide useful information for patients with acute PE. In this study, we aimed to investigate the diagnostic value of the QRS duration and RS time in inferolateral leads in patients admitted to the emergency department, and pre-diagnosed with acute (...) PE.We retrospectively enrolled 136 consecutive patients, admitted to the emergency department, pre-diagnosed with the clinical suspicion of acute PE, and underwent computerized tomographic pulmonary angiography (CTPA) to confirm the PE diagnosis. The study subjects were divided into two groups according to the presence or absence of PE, and the independent predictors of PE were investigated.Sixty-eight patients (50%) had PE. Patients with PE had a longer RS time. Among the ECG parameters, only RS

2019 EvidenceUpdates

3. What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? (SRS diagnosis)

What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? (SRS diagnosis) What Is the Best Imaging Study to Rule Out Pulmonary Embolism in Pregnancy? TAKE-HOME MESSAGE Both computed tomography (CT) pulmonary angiography and lung scintigraphy (ie, ventilation-perfusion scan) are appropriate imaging options for exclusion of pulmonary embolism during pregnancy. EBEM Commentators Latha Ganti, MD, MBA David Lebowitz, MD Department of Clinical Sciences University of Central Florida (...) College of Medicine Orlando, FL Jestin N. Carlson, MD, MS, and Alan Jones, MD, serve as editors of the SRS series. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS) series. The source for this systematic review snapshot is: van Mens TE, Scheres LJJ, de Jong PG, et al. Imaging for theexclusion of pulmonary embolism in pregnancy. Cochrane Database Syst Rev. 2017;1:CD011053. Results Summary of results for the diagnosis of pulmonary embolism

2018 Annals of Emergency Medicine Systematic Review Snapshots

4. Update: D-dimer Test for Excluding the Diagnosis of Pulmonary Embolism

Update: D-dimer Test for Excluding the Diagnosis of Pulmonary Embolism TAKE-HOME MESSAGE Patients with a low pretest probability for pulmonary embolism according to a structured clinical prediction rule and a negative D-dimer result are unlikely to have pulmonary embolism, particularly among those younger than 65 years. Update: D-dimer Test for Excluding the Diagnosis of Pulmonary Embolism EBEM Commentators Daniel Kwon, BS Lake Erie College of Osteopathic Medicine Erie, PA Melody Milliron, DO (...) appears to be safe because of its high sensitivity; however, the poor speci?city continues to subject a large proportion of patients with false- positive D-dimer test results to unnecessaryradiation exposure. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS) series. The source for this systematic review snapshot is: Crawford F, Andras A, Welch K, et al. D-dimer test for excluding the diagnosis of pulmonary embolism. Cochrane Database Syst Rev

2017 Annals of Emergency Medicine Systematic Review Snapshots

5. Pulmonary Embolism Diagnosis and Treatment

Pulmonary Embolism Diagnosis and Treatment ? 2017 Kaiser Foundation Health Plan of Washington. All rights reserved. 1 Pulmonary Embolism Diagnosis & Treatment Guideline Background 2 Evaluation and Diagnosis Adults 3 Pregnant women 4 Adults with cancer 5 Choice of Treatment Setting 6 Subsegmental PE: Treatment Versus Surveillance 8 Treatment with Anticoagulation Medications 9 Recommended testing 9 Choice of anticoagulant medications by population 9 Dosing of anticoagulant medications 11 Duration (...) a short in-hospital observation period. The recent American College of Chest Physicians Guidelines (2016) suggest treatment at home or early discharge over standard discharge for patients with low-risk PE (2B recommendation). Many physicians still have concerns regarding the outpatient treatment or early discharge of low-risk PE patients (Singer 2016). The purpose of this guideline is five-fold: • Provide an evidence-based approach to the diagnosis and management of acute pulmonary embolism

2017 Kaiser Permanente Clinical Guidelines

6. Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism

Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism | CADTH.ca Find the information you need Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism Published on: March 1, 2018 Project Number: OP0528-000 Product Line: Research Type: Other Diagnostics Result type: Report Pulmonary embolism (PE) is a blockage of one of the arteries in the lung (...) , SPECT/CT, Single-Photon, Tomography Scanners, V/Q scan, Wells, X-Ray Computed, cardiac echo, d-dimer, lung embolism, pulmonary embolism rule out criteria, thoracic ultrasound, ventilation-perfusion scan, ventilation/perfusion scan Optimal Use Report In Brief PUBLISHED : March 2018 Optimal Use Report Recommendations PUBLISHED : March 2018 Optimal Use Report Infographic PUBLISHED : August 2018 Optimal Use Report Science Report PUBLISHED : January 2018 Optimal Strategies for the Diagnosis of Acute

2018 CADTH - Optimal Use

7. D-dimer test for excluding the diagnosis of pulmonary embolism. (PubMed)

D-dimer test for excluding the diagnosis of pulmonary embolism. Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms (...) with expensive diagnostic tests.To investigate the ability of the D-dimer test to rule out a diagnosis of acute PE in patients treated in hospital outpatient and accident and emergency (A&E) settings who have had a pre-test probability (PTP) of PE determined according to a clinical prediction rule (CPR), by estimating the accuracy of the test according to estimates of sensitivity and specificity. The review focuses on those patients who are not already established on anticoagulation at the time of study

2016 Cochrane

8. Should Patients Who Receive a Diagnosis of Acute Pulmonary Embolism and Have Evidence of Right Ventricular Strain Be Treated With Thrombolytic Therapy?

Should Patients Who Receive a Diagnosis of Acute Pulmonary Embolism and Have Evidence of Right Ventricular Strain Be Treated With Thrombolytic Therapy? TAKE-HOME MESSAGE There is evidence to suggest a small mortality bene?t with the administration of thrombolytics for hemodynamically stable pulmonary embolism patients with right ventricular strain, but this bene?t must be weighed against the signi?cantly increased risk of major bleeding. Should Patients Who Receive a Diagnosis of Acute (...) Pulmonary Embolism and Have Evidence of Right Ventricular Strain Be Treated With Thrombolytic Therapy? EBEM Commentator Melinda J. Morton, MD, MPH Department of Emergency Medicine Johns Hopkins University School of Medicine Baltimore, MD Results Commentary Previous systematic reviews have not consistently reported a reduc- tioninmortalitywiththrombolytic therapy for an unselected popula- tion of patients with pulmonary embolism. 2 The American Heart Association currently recommends that providers

2016 Annals of Emergency Medicine Systematic Review Snapshots

9. D-Dimer Use and Pulmonary Embolism Diagnosis in Emergency Units: Why Is There Such a Difference in Pulmonary Embolism Prevalence between the United States of America and Countries Outside USA? (PubMed)

D-Dimer Use and Pulmonary Embolism Diagnosis in Emergency Units: Why Is There Such a Difference in Pulmonary Embolism Prevalence between the United States of America and Countries Outside USA? Although diagnostic guidelines are similar, there is a huge difference in pulmonary embolism (PE) prevalence between the United States of America (US) and countries outside the USA (OUS) in the emergency care setting. In this study, we prospectively analyze patients' characteristics and differences (...) in OUS (10.7%) than in the US (2.5%) (P < 0.0001). The mean number of imaging procedures performed for one new PE diagnosis was 3.3 in OUS vs 17 in the US (P < 0.001). Stopping investigation in the case of negative D-dimers (DD combined) with low/moderate PTP was more frequent in OUS (92.7%) than in the US (75.7%) (P < 0.01). Moreover, the use of imaging was much higher in the US (44.4% vs 19.2% in OUS) in the case of moderate PTP combined with negative DD.Differences between US and OUS PE prevalence

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2017 PLoS ONE

10. Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol

Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol | CADTH.ca CADTH Document Viewer Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol Table of Contents Search this document Addendum to Optimal Strategies (...) for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol October 2016 Ethics Review This protocol was written a priori and will be followed throughout the review process. There are two broad normative questions to consider regarding diagnosis of acute pulmonary embolism (PE): Should we provide diagnosis of acute PE? If yes, which strategies should be provided, and how best should those strategies be provided to diagnose those with acute PE? Both of these questions

2016 CADTH - Optimal Use

11. Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol

Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol | CADTH.ca CADTH Document Viewer Addendum to Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol Table of Contents Search this document Addendum to Optimal Strategies (...) for the Diagnosis of Acute Pulmonary Embolism: A Health Technology Assessment – Project Protocol October 2016 Ethics Review This protocol was written a priori and will be followed throughout the review process. There are two broad normative questions to consider regarding diagnosis of acute pulmonary embolism (PE): Should we provide diagnosis of acute PE? If yes, which strategies should be provided, and how best should those strategies be provided to diagnose those with acute PE? Both of these questions

2016 CADTH - Optimal Use

12. Optimal Diagnosis for Suspected Acute Pulmonary Embolism

Optimal Diagnosis for Suspected Acute Pulmonary Embolism Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism | CADTH.ca Find the information you need Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism Optimal Strategies for the Diagnosis of Acute Pulmonary Embolism Published on: March 1, 2018 Project Number: OP0528-000 Product Line: Research Type: Other Diagnostics Result type: Report Pulmonary embolism (PE) is a blockage of one of the arteries in the lung, frequently (...) , SPECT/CT, Single-Photon, Tomography Scanners, V/Q scan, Wells, X-Ray Computed, cardiac echo, d-dimer, lung embolism, pulmonary embolism rule out criteria, thoracic ultrasound, ventilation-perfusion scan, ventilation/perfusion scan Optimal Use Report In Brief PUBLISHED : March 2018 Optimal Use Report Recommendations PUBLISHED : March 2018 Optimal Use Report Infographic PUBLISHED : August 2018 Optimal Use Report Science Report PUBLISHED : January 2018 Optimal Strategies for the Diagnosis of Acute

2016 CADTH - Optimal Use

13. A novel electrocardiographic parameter for diagnosis of acute pulmonary embolism: RS time: RS time in acute pulmonary embolism. (PubMed)

A novel electrocardiographic parameter for diagnosis of acute pulmonary embolism: RS time: RS time in acute pulmonary embolism. Pulmonary embolism (PE) is one of the leading causes of cardiovascular mortality worldwide. Electrocardiography (ECG) may provide useful information for patients with acute PE. In this study, we aimed to investigate the diagnostic value of the QRS duration and RS time in inferolateral leads in patients admitted to the emergency department, and pre-diagnosed with acute (...) PE.We retrospectively enrolled 136 consecutive patients, admitted to the emergency department, pre-diagnosed with the clinical suspicion of acute PE, and underwent computerized tomographic pulmonary angiography (CTPA) to confirm the PE diagnosis. The study subjects were divided into two groups according to the presence or absence of PE, and the independent predictors of PE were investigated.Sixty-eight patients (50%) had PE. Patients with PE had a longer RS time. Among the ECG parameters, only RS

2018 American Journal of Emergency Medicine

14. Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study. (PubMed)

Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study. Data on the optimal diagnostic management of pregnant women with suspected pulmonary embolism (PE) are limited, and guidelines provide inconsistent recommendations on use of diagnostic tests.To prospectively validate a diagnostic strategy in pregnant women with suspected PE.Multicenter, multinational, prospective diagnostic management outcome study involving pretest clinical probability (...) assessment, high-sensitivity D-dimer testing, bilateral lower limb compression ultrasonography (CUS), and computed tomography pulmonary angiography (CTPA). (ClinicalTrials.gov: NCT00740454).11 centers in France and Switzerland between August 2008 and July 2016.Pregnant women with clinically suspected PE in emergency departments.Pulmonary embolism was excluded in patients with a low or intermediate pretest clinical probability and a negative D-dimer result. All others underwent lower limb CUS

2018 Annals of Internal Medicine

15. Clinical Value of Ultrasonography in Diagnosis of Pulmonary Embolism in Critically Ill Patients (PubMed)

Clinical Value of Ultrasonography in Diagnosis of Pulmonary Embolism in Critically Ill Patients Pulmonary embolism (PE) is a clinical emergency that will increase the mortality if complicated with unstable hemodynamics. Because of its nonspecific clinical symptoms, it's a great challenge to make a PE diagnosis. The golden standard to diagnose PE is computed tomography of pulmonary artery (CTPA), but a diagnosis of PE also composed of evaluation of PE risk factors, possibilities, and risk (...) stratification. Ultrasonography may detect right ventricle strain related to hemodynamic change, intravascular thrombosis, thrombosis in right heart or pulmonary arteries, pulmonary infarction, and local pleural effusion. Combination of ultrasound and traditional PE possibility evaluation score may further improve the pretest probability of CTPA. A comprehensive ultrasonography may sometimes rule out PE and may disclose other causes for the clinical situations. A heart-lung-vessel-integrated multiorgan

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2017 Journal of translational internal medicine

16. Pulmonary Embolism (PE): Diagnosis

Pulmonary Embolism (PE): Diagnosis © 2015 Thrombosis Canada Page 1 of 1 PULMONARY EMBOLISM (PE): DIAGNOSIS OBJECTIVE: To provide a diagnostic approach to patients with suspected acute pulmonary embolism (PE). BACKGROUND: Venous thromboembolism (VTE) is a common disease, affecting approximately 1-2 in 1,000 adults per year. Approximately one third of first VTE presentations are due to PE while the remainder is due to deep vein thrombosis (DVT). The diagnosis of PE has increased significantly (...) Canada Page 4 of 4 ? Deep Vein Thrombosis (DVT): Diagnosis ? Deep Vein Thrombosis (DVT): Treatment ? Pregnancy: Venous Thromboembolism Treatment ? Pulmonary Embolism (PE): Treatment ? Rivaroxaban (Xarelto ? ) ? Unfractionated Heparin and Low-molecular-weight Heparin ? Vena Cava Filter ? Venous Thromboembolism: Duration of Treatment ? Warfarin REFERENCES: Konstantinides SV, et al. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014;35(43):3033-3080. Raja

2015 Thrombosis Interest Group of Canada

17. Diagnosis of suspected acute pulmonary embolism in pregnancy: protocol for a systematic review and individual patient data meta-analysis (IPDMA)

Diagnosis of suspected acute pulmonary embolism in pregnancy: protocol for a systematic review and individual patient data meta-analysis (IPDMA) Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

18. Accuracy and Interobserver Reliability of the Simplified Pulmonary Embolism Severity Index Versus the Hestia Criteria for Patients With Pulmonary Embolism

Accuracy and Interobserver Reliability of the Simplified Pulmonary Embolism Severity Index Versus the Hestia Criteria for Patients With Pulmonary Embolism The objective was to assess and compare the accuracy and interobserver reliability of the simplified Pulmonary Embolism Severity Index (sPESI) and the Hestia criteria for predicting short-term mortality in patients with pulmonary embolism (PE).This prospective cohort study evaluated consecutive eligible adults with PE diagnosed (...) in the emergency department (ED) at a large, tertiary, academic medical center in the era January 1, 2015, to December 30, 2017. We assessed and compared sPESI and Hestia criteria prognostic accuracy for 30-day all-cause mortality after PE diagnosis and their interobserver reliability for classifying patients as low risk or high risk. Two clinician investigators scored both prediction tools during the ED evaluation. We used the kappa statistic to test for agreement.The 488-patient cohort had a mean (±SD) age

2018 EvidenceUpdates

19. Pulmonary embolism

Pulmonary embolism Pulmonary embolism - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Pulmonary embolism Last reviewed: February 2019 Last updated: July 2018 Summary Pulmonary embolism (PE) is a life-threatening condition resulting from dislodged thrombi occluding the pulmonary vasculature; right heart failure and cardiac arrest may ensue if not aggressively treated. Symptoms include chest pain, dyspnoea, and a sense (...) , and supportive care. For those at intermediate risk of a poor outcome, anticoagulation and ongoing monitoring is required and rescue re-perfusion should be considered. Ongoing anticoagulation therapy is indicated to reduce the risk of recurrent events or fatal PE. Definition Pulmonary embolism (PE) is a consequence of thrombus formation within a deep vein of the body, most frequently in the lower extremities. Thrombus formation in the venous system occurs as a result of venous stasis, trauma

2018 BMJ Best Practice

20. Diagnosis and Management of Acute Pulmonary Embolism

Diagnosis and Management of Acute Pulmonary Embolism ESC GUIDELINES 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS) Authors/Task Force Members: Stavros V. Konstantinides * (Chairperson) (Germany/ Greece), Adam Torbicki * (Co-chairperson) (Poland), Giancarlo Agnelli (Italy), Nicolas Danchin (...) classi?cation of pulmonary embolism severity . . .3039 3. Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3039 3.1 Clinical presentation . . . . . . . . . . . . . . . . . . . . . . . .3039 3.2 Assessment of clinical probability . . . . . . . . . . . . . . . .3040 3.3 D-dimer testing . . . . . . . . . . . . . . . . . . . . . . . . . . .3040 3.4 Computed tomographic pulmonary angiography . . . . . .3042 3.5 Lung scintigraphy

2014 European Society of Cardiology

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