By American College of Chest Physicians
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0 Total score 0 to 3, low pretest probability 4 to 10, moderate pretest probability Ն 11, high pretest probability *Adapted from Tapson VF. Acute pulmonary embolism. N Engl J Med 2008; 358:1037–1052. finding provides compelling evidence against the diagnosis of PE. In one study of 515 consecutive patients with clinically suspected PE who had anticoagulation therapy withheld on the basis of a normal perfusion scan finding, only 3 patients had symptomatic VTE (PE, 1 patient) during a 3-month follow-up period.
Multiple-hit hypothesis of pathogenesis of PAH: BMPR-II, bone morphogenic protein receptor type 2. From Gabbay E, Reed A, Williams TJ. Assessment and treatment of pulmonary arterial hypertension: an Australian perspective in 2006. Intern Med J 2006; 37:38−48. PAH related to risk factors or associated conditions is a heterogeneous group of disorders, including connective tissue disease, congenital systemic pulmonary shunt, portal hypertension, HIV infection, drugs and toxin, and those conditions such as hemoglobinopathies and myeloproliferative disorders.
When the . PIOPED criteria are used, a high-probability V/Q lung scan finding accompanied with a high prescan clinical suspicion is. associated with confirmed PE in Ͼ 96% of cases. V/Q scan patterns other than normal or high-probability patterns will require additional diagnostic evaluation. Spiral CT pulmonary angiography (CTPA) of the pulmonary circulation has emerged as the Pulmonary Vascular Diseases (Moores) 7/10/09 8:03:53 PM primary diagnostic method for the evaluation of PE. As a minimally invasive examination, this technique is widely available and has replaced the use of conventional pulmonary angiography in most centers.
ACCP pulmonary medicine board review by American College of Chest Physicians