Diagnostic Requirements And Therapeutic Decisions In Pulmonary Embolism

Arthur A. Sasahara, MD; E. James Potchen, MD; Duncan P. Thomas, MD, PhD; Henry N. Wagner, MD; W. Clayton Davis, MD
JAMA. 1967;202(6):553. doi:10.1001/jama.1967.03130190159042.
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To the Editor:—  One of the most important clinical problems in pulmonary embolic disease is to decide upon the minimal diagnostic criteria for the institution of therapy. In view of the current array of newer diagnostic methods, it becomes important for the clinician to select judiciously, those studies which are most likely to help. It is unrealistic to insist that every patient with suspected pulmonary embolic disease be studied in the same manner. In all patients, however, an awareness of the possibility together with a good history and physical examination are the best aids to diagnosis; in some patients these will be sufficient. A suggested approach to the problem of adequate diagnostic studies and when to start therapy is as follows:

  1. Minor Symptoms: Patients with minor symptoms and signs suggestive of pulmonary embolism commonly complain of transient or mild dyspnea and occasionally of pleural pain. They may have minimal


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