When patients present with chest pain, clinicians must quickly determine if the cause is cardiac‐related, a pulmonary embolism (PE), or another condition. PE is a common and potentially lethal condition, and rapid assessment and treatment of PE can result in a dramatic reduction of morbidity and mortality.
Approximately 10% of diagnosed acute PE patients die within 60 minutes. PE is so common and lethal that the American Public Health Association recommends that diagnosis be sought actively in every patient who presents with any chest symptoms that cannot be proven to have another cause.1
Guidelines for Assessing Venous Thromboembolism (VTE)
The American College of Emergency Physicians issued clinical policies2,3 for evaluating patients with suspected venous thromboembolism (VTE). They recommend, in patients with a low clinical or pretest probability, a lower extremity DVT or PE can be ruled out with:
- A negative quantitative D‐dimer assay
- A negative whole‐blood‐cell qualitative D‐dimer assay in conjunction with the Wells Pretest Probability Scoring System
1. American Public Health Association. Deep vein thrombosis: advancing awareness to protect patient lives. 2003 Feb 26.
2. Plaut D, Shafer D. Advance/Laboratory. 2002;3:1‐5
3. Brown MD, et al. Annals of Emergency Medicine. 2002;40:133‐144.