Diagnosing Pulmonary Embolism (PE)
A pulmonary embolism is a blockage in one of the arteries in the lungs. It occurs when a blood clot, known as a thrombus, travels from another part of the body and gets lodged in the lung's blood vessels.
To diagnose pulmonary embolism (PE), doctors use a combination of examinations, screening tests, and procedures. These include:
- Medical history: Your doctor will ask about your symptoms, medical history, and any risk factors for blood clots.
- Physical exam: During a physical exam, the doctor will look for swollen or discolored areas on your arms or legs, listen to your heart and lungs, and take your blood pressure.
- Blood tests: Doctors may order a D-dimer blood test. D-dimer is a substance present in the bloodstream when a blood clot dissolves. High levels can indicate the presence of a blood clot.
- Medical imaging: Various imaging tests can help confirm a diagnosis of PE. These include:
- Computed tomography pulmonary angiography (CTPA): This is the primary method for detecting PE. It takes pictures of your blood vessels and looks for blood clots in the lungs.
- Pulmonary ventilation/perfusion (V/Q) scan: This test uses X-ray scans to show the flow of air and blood in the lungs.
- Ultrasound: An ultrasound can measure blood flow and help identify any clots.
- Magnetic resonance imaging (MRI): MRI may be used for pregnant individuals or those who cannot tolerate contrast dyes used in other imaging techniques. It can provide detailed images of the legs or lungs.
These examinations, screening tests, and procedures help confirm a diagnosis of PE by identifying signs such as blood clots in the lungs or abnormal blood flow.
Specialists who may be involved in diagnosing PE include:
- Pulmonologists: Doctors who specialize in lung diseases
- Cardiologists: Doctors who specialize in heart diseases
- Radiologists: Doctors who interpret medical images
- Hematologists: Doctors who specialize in blood disorders
To determine the type, severity, or risk level of a PE, additional examinations, tests, or procedures may be done. These can identify factors or indicators such as:
- Pulmonary angiography: This test confirms PE if other tests are inconclusive. It involves inserting a tube into a blood vessel and using X-rays to create videos of blood flow to identify any clots.
- Additional imaging tests: These can look at heart function, lung function, and how well blood flows through veins if previous tests could not diagnose or rule out PE.
It's important to note that while these diagnostic methods are commonly used, it's always best to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan.