New diagnostic and treatment modalities for pulmonary embolism: one path through the confusion.

摘要: Pulmonary embolism is one of the greatest diagnostic challenges in emergency medicine. New techniques and strategies constantly arise for diagnosis treatment this disease. A review new modalities pulmonary (PE) suggests that it should be suspected any patient with unexplained dyspnea, tachypnea, or chest pain. All patients PE must risk stratified, ideally a criteria-validated clinical decision rule. After assessing pre-test probability, D-dimer assays will reliably exclude low group no further imaging warranted. Computed tomography (CT) angiogram initial study choice stable patients. V/Q scans used only when CT not available if has contraindication to intravenous contrast. Bedside echocardiography stabilization are tests massive PE. If confirmed, hypotensive treated thrombolytics. Both heparin molecular weight equally effective treatments confirmed Because accurate screening identification frequently requires more than single test, knowledge existing allows an evidence-based strategy diagnosis. therapeutic choices may benefit embolism.