When Is a Computed Tomography Angiogram Necessary to Rule Out Pulmonary Embolus in the Emergency Department?

By Joel Handler, MD


Winter 2008 - Volume 12 Number 1


Case Examples

A previously healthy woman, age 25 years, presented in the Emergency Department (ED) with sudden onset of pleuritic chest pain. She said that she had had no cough, fever, or chills; she took birth-control pills. Physical examination showed the patient to be comfortable breathing room air and to have a pulse oximetry saturation of 92%, respiration rate of 18 breaths per minute, blood pressure of 118/62 mm Hg, and a heart rate of 74 beats per minute. There was no chest wall tenderness and no calf or popliteal tenderness or swelling. A telephone advice nurse had recommended that she go to the ED.


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