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Pulmonary Embolism

Pulmonary Embolism. Radiologic Evaluation. Lucas Faulkenberry M4. Objectives. Understand radiologic studies used to identify pulmonary embolism Identify abnormalities in these studies Review the new algorithm for evaluating suspected PE. Pulmonary Embolism. Non-specific symptoms CP SOB

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Pulmonary Embolism

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  1. Pulmonary Embolism Radiologic Evaluation Lucas Faulkenberry M4

  2. Objectives • Understand radiologic studies used to identify pulmonary embolism • Identify abnormalities in these studies • Review the new algorithm for evaluating suspected PE

  3. Pulmonary Embolism • Non-specific symptoms • CP • SOB • Tachycardia • Tachypnea • Cough • Hemoptysis • Frequent autopsy finding • 80% associated with DVT

  4. Diagnostic Efforts in Radiology • reaching an acceptable level of diagnostic certainty of PE to warrant anticoagulant therapy, using the least invasive tests • eliminating other reasons for the patient's symptoms

  5. Acute Chest Pain with Suspected PE • Leg doppler • CXR • V/Q Scan • CTPA • Pulmonary Angiography

  6. Leg Doppler • Quick • Cheap • Non-invasive • Positive test leads to same treatment

  7. Chest X-Ray • Important initially to rule out obvious causes of CP • Abnormal in 88% • Hampton’s Hump • Westermark Sign

  8. V/Q Scan • Not as widely used • Allergy or pregnancy • PIOPED criteria

  9. Computed Tomography Pulmonary Angiography • New standard for suspected PE • Fast • High sensitivity and specificity • Few contraindications

  10. Pulmonary Angiography • Used less often • Confirmation or indeterminate cases • Invasive

  11. Review • Imaging studies used to evaluate suspected PE • Practice identifying abnormalities in these studies • Review the new algorithm for evaluating suspected PE

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