A hard diagnosis. Seek especially a history of:
- Sudden Onset Dyspnea — Within 30-60 seconds in almost 75% of patients. When someone remembers the exact moment their dyspnea began, think PE.
Also suspect a PE based on risk factors, & perhaps other clinical findings:
Top Risk Factors for PE
Clinical Findings Suggesting PE
Finally, another very predictive parameter: “no other diagnosis more likely.” If you think a PE is not unlikely, send the patient to an E.D.
E.D. work-up: stat D-dimer combined with clinical probability score to decide if the case warrants a CT or ventilation/perfusion [V/Q] scan.
See posting Acute Dyspnea – 2.