The diagnosis of pulmonary embolism: a review with particular reference to the use of radionuclides

Abstract

Summary Pulmonary embolism was first recognized as an important entity early in the nineteenth century. The evolution of our knowledge of this disorder has been reviewed with particular emphasis on the various diagnostic techniques which have been used to assist in its recognition. These have included physical examination to demonstrate the presence of classical physical signs, electrocardiography, biochemical tests, radiological examinations, pulmonary function tests, ultra-sound and methods employing radionuclides. The wide variety of techniques applied to this problem clearly indicates that no currently available test is entirely satisfactory alone. Probably the most significant advance in recent years has been the development of lung perfusion scanning which has provided at the very least a valuable screening test and a ready method of studying serially the natural history of the perfusion defects produced by thromboembolic disease.

Phlebography in the management of pulmonary embolism

“…While sudden acute cardiorespiratory collapse associated with massive embolus can often be diagnosed, many patients with small peripheral emboli frequently present with clinical, radiological and electrocardiographic features which may be confused with postoperative atelectasis, pneumonia, pleurisy or myocardial infarction. Other diagnostic aids, including lung scanning and pulmonary angiography, may also fail to demonstrate such emboli (Hildner and Ormond, 1967;Freeman et al, 1968;Cook and Lander, 1971).…”