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Recent Advances in Chest Medicine |

Current Approach to the Diagnosis of Acute Nonmassive Pulmonary EmbolismDiagnosis of Pulmonary Embolism

COL Lisa K. Moores, MD, MC, USA, FCCP; MAJ Christopher S. King, MD, MC, USA; MAJ Aaron B. Holley, MD, MC, USA
Author and Funding Information

From the Department of Medicine, the Uniformed Services University of the Health Sciences (Dr Moores), Bethesda, MD; the Pulmonary and Critical Care Medicine Service, William Beaumont Army Medical Center (Dr King), El Paso, TX; and the Pulmonary, Critical Care, and Sleep Medicine Service (Dr Holley), Walter Reed Army Medical Center, Washington, DC.

Correspondence to: COL Lisa K. Moores, MD, MC, USA, FCCP, Office for Student Affairs, The Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; e-mail: lmoores@usuhs.mil


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(2):509-518. doi:10.1378/chest.10-2468
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Pulmonary embolism is a common and potentially lethal disease. Given the variable presentation and associated morbidity of this condition, an accurate and efficient diagnostic algorithm is required. Clinical pretest probability serves as the root of any diagnostic approach. We, thus, review several clinical decision rules that may help standardize this determination. Using a review of the literature, the accuracy, predictive values, and likelihood ratios for several diagnostic tests are described. The combination of these tests, based on the pretest probability of disease, can be used in a Bayesian fashion to make accurate treatment decisions. A completely noninvasive diagnostic algorithm for patients presenting with suspected acute pulmonary embolism is proposed.

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