MURRILL M. SZUCS JR., M.D.; HAROLD L. BROOKS, M.D.; WILLIAM GROSSMAN, M.D.; JOHN S. BANAS JR., M.D.; STEVEN G. MEISTER, M.D.; LEWIS DEXTER, M.D., F.A.C.P.; JAMES E. DALEN, M.D.
Many different laboratory tests have been used to screen patients for pulmonary embolism. The sensitivity of certain laboratory tests was assessed in a prospective study of 50 patients with angiographically documented acute pulmonary embolism. Electrocardiographic evidence of right heart strain occurred in only nine patients; each had massive pulmonary embolism. Nonspecific chest X-ray abnormalities (infiltrate, effusion, or elevated diaphragm) occurred in 71%; 29% had a normal chest X ray. Lactic dehydrogenase (LDH) was increased in 83% of the patients, but serum glutamic-oxalacetic transaminase (SGOT) and bilirubin were of little value. The triad of increased LDH, normal SGOT, and increased bilirubin occurred in only 12%. Lung scans performed in 24 patients were abnormal. Arterial Po2 (breathing room air) was decreased (≤ 80 mm Hg) in all 36 patients tested. Arterial Po2 and lung scan are the most sensitive tests for screening; if either is normal, acute pulmonary embolism is essentially excluded.
SZUCS MM, BROOKS HL, GROSSMAN W, et al. Diagnostic Sensitivity of Laboratory Findings in Acute Pulmonary Embolism. Ann Intern Med. 1971;74:161–166. doi: https://doi.org/10.7326/0003-4819-74-2-161
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Published: Ann Intern Med. 1971;74(2):161-166.
Emergency Medicine, Pulmonary Embolism, Pulmonary/Critical Care, Venous Thromboembolism.
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