The European Society of Cardiology (ESC) proposed several algorithms for patients with suspected pulmonary embolism. One algorithm relates to low or intermediate risk patients.
Patient selection: suspected PE without shock or hypotension
Parameters:
(1) clinical probability of pulmonary embolism (by clinical judgment or decision rule)
(2) CT angiography (positive if PE at segmental or more proximal level)
(3) plasma D-dimer
Management options:
(1) anticoagulation or other therapy
(2) no treatment
(3) further investigation
Clinical Probability
D-dimer
CT Angiography
Management
low or intermediate
negative
NA
no treatment
low or intermediate
positive
negative
no treatment
low or intermediate
positive
positive
anticoagulation
high
NA
negative
no treatment; consider further investigation
high
NA
positive
anticoagulation
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