Pulmonary Embolism

How do we diagnose a Pulmonary Embolism?

Computed Tomography (CT):
CT and computed tomography angiography (CTA) are the most accurate tests to detect pulmonary embolisms.
For more information about CTA exams please see
https://www.radiologyinfo.org/en/info.cfm?pg=angioct.

Ventilation and Perfusion (V/Q) scan:
A V/Q scan uses an injection to see the blood flow to the lungs and an inhaled tracer to see the airflow in the lungs.  When there is less blood flow to a segment of the lung this can indicate a pulmonary embolism.
For more information about V/Q exams please see
https://www.radiologyinfo.org/en/info.cfm?pg=angioct.

Ventilation and Perfusion (V/Q) scan:
A V/Q scan uses an injection to see the blood flow to the lungs and an inhaled tracer to see the airflow in the lungs.  When there is less blood flow to a segment of the lung this can indicate a pulmonary embolism.
For more information about V/Q exams please see
https://www.radiologyinfo.org/en/info.cfm?pg=angioct.

How do we treat a Pulmonary Embolism?

Most pulmonary embolic disease is treated simply with blood thinning medications.  However, if an embolism is detected one of the first things done is to look in the extremities to see if there is more clot.  If there is more clot if it breaks free the embolism can get larger and more dangerous.  Venous clot is detected by the use of venous ultrasound.

Venous Ultrasound:
The veins in the legs and sometimes the arms are examined with ultrasound to detect any blood clots which may break free and travel to the lungs.
For more information on venous ultrasound please see
https://www.radiologyinfo.org/en/info.cfm?pg=venousus

IVC Filter
If there is enough clot left in the legs a filter can be placed in the main vein in the belly, the inferior vena cava (IVC).  This filter can catch clot traveling upwards from the legs before it gets to the lungs.
For more information on IVC filters please see
https://www.radiologyinfo.org/en/info.cfm?pg=VenaCavaFilter

Pulmonary Thrombolysis:
If the clot is very large and immediately life threatening further treatment may be needed where a catheter is fed through the veins in the groin up to the clot in the chest.  From there clot busting medication can be given which will dissolve the clot (thrombolysis) or the clot may be removed directly.
For more information on catheter directed thrombolysis please see
https://www.radiologyinfo.org/en/info.cfm?pg=thrombo