Patients with unexplained chest pain, shortness of breath, or tachycardia should undergo diagnostic testing for pulmonary embolism even without classical symptoms to prevent delayed diagnosis.
Non-classical presentations were associated with delayed PE diagnosis; leaves open whether broader testing in unexplained symptoms improves outcomes.
Pulmonary embolism is a common and potentially life threatening condition. Delays in pulmonary embolism diagnosis represent an important problem. It is crucial to have early diagnosis of pulmonary embolism if one wishes to reduce its complication. We retrospectively reviewed our patients who visited our emergency department with a final diagnosis of pulmonary embolism. We found that delayed diagnosis of pulmonary embolism usually happened when patients did not present with the classical symptoms and signs leading to other medical diagnosis at first. Clinical signs and symptoms for pulmonary embolism are mostly non-specific; therefore, patients suspected of having pulmonary embolism—because of unexplained chest pain, shortness of breath or tachycardia with or without the risk factors for pulmonary embolism—must undergo diagnostic tests including D-dimer or CT pulmonary angiography if indicated until the diagnosis is ruled out.
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Hsieh et al. (2012) studied this question.
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