Pulmonary thromboembolic disease

Diagnostic imaging for acute pulmonary embolism has evolved; CT angiography of the chest is now considered the gold standard for diagnosis. The chest radiograph has limited utility, but can occasionally detect an alternative diagnosis. Although not frequently used, ventilation/ perfusion scan can be diagnostic, particularly in the setting of a normal chest radiograph. Clinical features, including risk factors and presenting signs and symptoms, should be utilized to assess pre-test probability and guide diagnostic imaging choices. Unique situations, such as renal failure and pregnancy, will potentially alter the diagnostic decisions.