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afya PulmonaryEmbolus

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20160425222533 Ben  
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''Features'' - difficult to diagnose as variable Sx
Classic triad - pleuritic chest pain, dyspnoea, haemoptysis - occurs in 10% pts 
frequency of signs ....
    Tachypnea (respiratory rate >16/min) - 96%
    Crackles - 58%
    Tachycardia (heart rate >100/min) - 44% (used by Wells - not tachypnoea
    Fever (temperature >37.8°C) - 43%

''manage ...''
Hx Ex CXR ... if PE suspected do ''Wells score'' (use MDcalc)
If PE 'likely' (>4)  do CTPA - with LMWH if delay
If PE 'unlikely' (<=4) do D-dimer
If D dimer positive do CTPA - with LMWH if delay
If allergy to contrast media or renal impairment do V/Q not CTPA.