What are the risk factors for pulmonary embolism and DVT? Certain patients are at higher risk for developing a pulmonary embolism or DVT. These include a prior history of blood clots, family history of blood clots, genetic predisposition to the hypercoagulable state, a active cancer diagnosis, recent surgery, medications such as birth control pills and periods of prolonged immobilization. A pulmonary embolism is usually diagnosed in the emergency room. Screening lab work with the d-dimer can be done to rule out pulmonary embolism in patients with a low probability of disease. If risk of pulmonary embolism is high, the CT angiogram of the chest is the diagnostic test of choice, which can highlight the blood clot in the pulmonary arteries. At the same time, ultrasound of either the arms or legs can be done to look for a concurrent DVT. If a patient cannot tolerate the use of IV contrast, then the VQ, or ventilation profusion nuclear medicine study of the lungs is performed.
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