Pulmonary Embolism (PE)
What Is It?
A blood clot lodging in the pulmonary arteries. Presents with sudden dyspnea, pleuritic chest pain, tachycardia, and hemoptysis. Can be life-threatening.
How Is It Diagnosed?
Wells PE score for pre-test probability. D-dimer if low probability. CT pulmonary angiography (CTPA) is gold standard. V/Q scan if contrast contraindicated.
How Is It Treated?
Hemodynamically stable: DOACs (apixaban, rivaroxaban). Submassive/massive: systemic thrombolysis or catheter-directed therapy. Anticoagulation minimum 3 months. IVC filter only in anticoagulation contraindication.
Tests and Imaging Typically Needed
D-dimer, troponin, BNP, CBC, BMP, EKG, echocardiogram, CTPA.
Approximate Self-Pay Costs
Emergency evaluation. Office follow-up: $95-$150. CTPA: $1,000-$2,500. DOACs: $400-$500/month.