Diagnostic imaging and risk stratification of patients with acute pulmonary embolism

Stephanie K. Burns, Linda B. Haramati

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Pulmonary embolism (Pe) is the third most common acute cardiovascular disease after myocardial infarction and stroke. The prompt diagnosis, risk stratification, and treatment of patients with acute Pe can reduce mortality. Multidetector row computed tomography pulmonary angiography (CTPA) is the most common study used to make the diagnosis of acute Pe. CTPA may additionally identify right heart dysfunction or alternative diagnoses. There is a growing body of evidence that computed tomography signs of right heart failure predict patients at higher risk of mortality. At the same time, CTPA has about a 6-fold greater whole body effective dose than ventilation-perfusion (V/Q) scintigraphy, and a much higher dose to breast tissue in particular. V/Q scintigraphy should be considered for patients with contraindications to iodinated contrast or for patients with normal chest radiographs, especially young women. Compression ultrasonography of the proximal lower extremities, an imaging study without ionizing radiation, should be considered for patients suspected of acute Pe with signs of lower extremity deep venous thrombosis or for patients with negative CTPA or V/Q scan with discordant clinical probability. This article reviews factors affecting the selection of the best imaging test for a particular patient suspected of acute Pe, performance characteristics of diagnostic imaging tests, and imaging findings that correlate with higher mortality.

Original languageEnglish (US)
Pages (from-to)15-24
Number of pages10
JournalCardiology in Review
Volume20
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

Diagnostic Imaging
Pulmonary Embolism
Lung
Radionuclide Imaging
Mortality
Lower Extremity
Multidetector Computed Tomography
Acute Disease
Ionizing Radiation
Routine Diagnostic Tests
Venous Thrombosis
Ventilation
Ultrasonography
Breast
Cardiovascular Diseases
Thorax
Heart Failure
Perfusion
Stroke
Myocardial Infarction

Keywords

  • computed tomography pulmonary angiography
  • pulmonary embolism
  • risk stratification
  • ventilation perfusion scintigraphy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Diagnostic imaging and risk stratification of patients with acute pulmonary embolism. / Burns, Stephanie K.; Haramati, Linda B.

In: Cardiology in Review, Vol. 20, No. 1, 01.2012, p. 15-24.

Research output: Contribution to journalArticle

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