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Although dyspnea at rest is a common symptom of pulmonary embolism (PE), whether PE causes isolated dyspnea on exertion is unclear. Researchers analyzed data from 417 consecutive patients (mean age, 58) who were evaluated in 14 emergency departments in Italy for moderate-to-severe exertional dyspnea for <1 month. Patients with previous venous thromboembolism, those on anticoagulation, or those older than 75 were excluded. PE was ruled out in patients with low pretest probability (using the simplified Wells score) and normal age-adjusted D-dimer level; all other patients underwent computed tomographic (CT) pulmonary angiography.
Key findings were:
Diagnosis of PE was excluded in 32% of patients based on low pretest probability and D-dimer, exc…