Clinical correlations in the diagnosis of pulmonary embolism.

This study of 73 patients with the clinical diagnosis of thromboembolism has shown that the pulse rate, respiratory rate, and arterial partial pressure of carbon dioxide have discriminatory value in identifying the group of acutely ill patients who are most likely to have pulmonary embolism. In contrast, the clinical diagnosis of deep venous thrombosis, PaO2 chest radiography and electrocardiography which are all essential to patient management have no such value. In this series, only 29% of the patients had a pulmonary arteriogram positive for thromboembolism, but the mortality rate in this group was 33%. Pulmonary perfusion scanning has been shown to be a useful and accurate screening investigation and should be routinely employed prior to pulmonary angiography if the patient is stable hemodynamically.