Diagnosis of pulmonary embolism

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Pulmonary embolism is the third cause of mortality by cardiovascular disease after coronary artery disease and stroke, and its incidence is around 1/1000 per year.
During the last two decades, many different non-invasive diagnostic tests have been developed and validated.
For hemodynamically stable outpatients,the diagnosis of acute pulmonary embolism mainly rests on the sequential use ofclinical assessment, D-dimer measurement and multidetector CT.
In patients with a contraindication to CT, lower limb venous ultrasonography and ventilation-perfusion scintigraphy remain valid options.
Massive pulmonary embolism is a distinct clinical entity with a specific diagnostic approach.In unstable patients with suspected pulmonary embolism,echocardiography should be the initial test.

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