How is venous thromboembolism (VTE) diagnosed?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

Workup for thromboembolism includes the following:

  • Pulmonary angiography: Diagnostic standard for PE
  • Ventilation-perfusion scanning: Most common screening technique
  • Venography: Standard test for validating new diagnostic procedures
  • Arterial blood gas values on room air: Hypoxemia, elevated alveolar-arterial oxygen gradient
  • Acid-base status: Respiratory alkalosis
  • Enzyme-linked immunoassay (ELISA) for D-dimer
  • Electrocardiography, especially for ruling out myocardial infarction
  • Chest radiography: Most often normal but occasionally suggestive
  • Helical (spiral) computed tomography of pulmonary vessels
  • Doppler ultrasonography of venous system
  • Echocardiography
  • Impedance plethysmography: Of limited value when DVT is asymptomatic or distal or when findings are nonocclusive

See Workup for more detail.


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