Clinical Validity of a Normal Perfusion Lung Scan in Patients with Suspected Pulmonary Embolism
The objective of this study was to test the safety of withholding anticoagulant therapy in patients with clinically suspected pulmonary embolism who have normal perfusion lung scans, regardless of the clinical manifestations. Anticoagulant therapy was withheld or withdrawn in 515 consecutive patient...
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| Veröffentlicht in: | Chest 1990-01, Vol.97 (1), p.23-26 |
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| creator | Hull, Russell D. Raskob, Gary E. Coates, Geoffrey Panju, Akbar A. |
| description | The objective of this study was to test the safety of withholding anticoagulant therapy in patients with clinically suspected pulmonary embolism who have normal perfusion lung scans, regardless of the clinical manifestations. Anticoagulant therapy was withheld or withdrawn in 515 consecutive patients except in patients in whom deep-vein thrombosis was detected. Only three of the 515 patients had symptomatic venous thromboembolism on follow-up. The frequency of symptomatic pulmonary embolism on follow-up was one of 515 patients. With knowledge of the normal findings by perfusion scanning, an alternative diagnosis was established in 367 of the 515 patients. Cause of symptoms remained uncertain in 148 patients. It is safe to withhold anticoagulant therapy in patients with suspected pulmonary embolism and normal perfusion scans, regardless of the clinical manifestations. The finding of a normal perfusion scan excludes the presence of clinically important pulmonary embolism and makes pulmonary angiography unnecessary.
(Chest 1990; 97:23-26) |
| doi_str_mv | 10.1378/chest.97.1.23 |
| format | Article |
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(Chest 1990; 97:23-26)</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.97.1.23</identifier><identifier>PMID: 2295242</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants - therapeutic use ; Biological and medical sciences ; Cardiology. Vascular system ; Chronic cor pulmonale ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Plethysmography, Impedance ; Pneumology ; Prospective Studies ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - diagnostic imaging ; Pulmonary Embolism - drug therapy ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Radionuclide Imaging ; Thromboembolism - diagnosis</subject><ispartof>Chest, 1990-01, Vol.97 (1), p.23-26</ispartof><rights>1990 The American College of Chest Physicians</rights><rights>1990 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-672f070c417996badefc4dbe87d5943f8078e1a604276bb5bd665b4dbf0058a43</citedby><cites>FETCH-LOGICAL-c403t-672f070c417996badefc4dbe87d5943f8078e1a604276bb5bd665b4dbf0058a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=6758418$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2295242$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hull, Russell D.</creatorcontrib><creatorcontrib>Raskob, Gary E.</creatorcontrib><creatorcontrib>Coates, Geoffrey</creatorcontrib><creatorcontrib>Panju, Akbar A.</creatorcontrib><title>Clinical Validity of a Normal Perfusion Lung Scan in Patients with Suspected Pulmonary Embolism</title><title>Chest</title><addtitle>Chest</addtitle><description>The objective of this study was to test the safety of withholding anticoagulant therapy in patients with clinically suspected pulmonary embolism who have normal perfusion lung scans, regardless of the clinical manifestations. Anticoagulant therapy was withheld or withdrawn in 515 consecutive patients except in patients in whom deep-vein thrombosis was detected. Only three of the 515 patients had symptomatic venous thromboembolism on follow-up. The frequency of symptomatic pulmonary embolism on follow-up was one of 515 patients. With knowledge of the normal findings by perfusion scanning, an alternative diagnosis was established in 367 of the 515 patients. Cause of symptoms remained uncertain in 148 patients. It is safe to withhold anticoagulant therapy in patients with suspected pulmonary embolism and normal perfusion scans, regardless of the clinical manifestations. The finding of a normal perfusion scan excludes the presence of clinically important pulmonary embolism and makes pulmonary angiography unnecessary.
(Chest 1990; 97:23-26)</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Chronic cor pulmonale</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Plethysmography, Impedance</subject><subject>Pneumology</subject><subject>Prospective Studies</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - diagnostic imaging</subject><subject>Pulmonary Embolism - drug therapy</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Radionuclide Imaging</subject><subject>Thromboembolism - diagnosis</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1990</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1vFCEYh4nR1LV69GjCwfQ2K18Dw9FsajXZ6CZtvRKGjy4NAyvM2PS_F91Ne_JE4H34_d48ALzHaI2pGD6ZvavzWoo1XhP6AqywpLijPaMvwQohTDrKJXkN3tR6j9odS34GzgiRPWFkBdQmhhSMjvCnjsGG-RFmDzX8nsvUHneu-KWGnOB2SXfw2ugEQ4I7PQeX5gofwryH10s9ODM7C3dLnHLS5RFeTmOOoU5vwSuvY3XvTuc5uP1yebP52m1_XH3bfN52hiE6d1wQjwQyDAsp-ait84bZ0Q3C9pJRPyAxOKw5YkTwcexHy3k_NsIj1A-a0XNwccw9lPxraUbUFKpxMerk8lKVkD0llPAGdkfQlFxrcV4dSpjaygoj9Veo-idUSaGwIrTxH07Byzg5-0SfDLb5x9Nc16bRF51MqE8YF_3A8PBcuw93-4dQnKrNb2yh9Fh4n5eSdHyuFUfeNWm_gyuqmqbcONv-mlnZHP6z8B_EGKLp</recordid><startdate>199001</startdate><enddate>199001</enddate><creator>Hull, Russell D.</creator><creator>Raskob, Gary E.</creator><creator>Coates, Geoffrey</creator><creator>Panju, Akbar A.</creator><general>Elsevier Inc</general><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199001</creationdate><title>Clinical Validity of a Normal Perfusion Lung Scan in Patients with Suspected Pulmonary Embolism</title><author>Hull, Russell D. ; Raskob, Gary E. ; Coates, Geoffrey ; Panju, Akbar A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-672f070c417996badefc4dbe87d5943f8078e1a604276bb5bd665b4dbf0058a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1990</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Chronic cor pulmonale</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Plethysmography, Impedance</topic><topic>Pneumology</topic><topic>Prospective Studies</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - diagnostic imaging</topic><topic>Pulmonary Embolism - drug therapy</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>Radionuclide Imaging</topic><topic>Thromboembolism - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hull, Russell D.</creatorcontrib><creatorcontrib>Raskob, Gary E.</creatorcontrib><creatorcontrib>Coates, Geoffrey</creatorcontrib><creatorcontrib>Panju, Akbar A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hull, Russell D.</au><au>Raskob, Gary E.</au><au>Coates, Geoffrey</au><au>Panju, Akbar A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Validity of a Normal Perfusion Lung Scan in Patients with Suspected Pulmonary Embolism</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>1990-01</date><risdate>1990</risdate><volume>97</volume><issue>1</issue><spage>23</spage><epage>26</epage><pages>23-26</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>The objective of this study was to test the safety of withholding anticoagulant therapy in patients with clinically suspected pulmonary embolism who have normal perfusion lung scans, regardless of the clinical manifestations. Anticoagulant therapy was withheld or withdrawn in 515 consecutive patients except in patients in whom deep-vein thrombosis was detected. Only three of the 515 patients had symptomatic venous thromboembolism on follow-up. The frequency of symptomatic pulmonary embolism on follow-up was one of 515 patients. With knowledge of the normal findings by perfusion scanning, an alternative diagnosis was established in 367 of the 515 patients. Cause of symptoms remained uncertain in 148 patients. It is safe to withhold anticoagulant therapy in patients with suspected pulmonary embolism and normal perfusion scans, regardless of the clinical manifestations. The finding of a normal perfusion scan excludes the presence of clinically important pulmonary embolism and makes pulmonary angiography unnecessary.
(Chest 1990; 97:23-26)</abstract><cop>Northbrook, IL</cop><pub>Elsevier Inc</pub><pmid>2295242</pmid><doi>10.1378/chest.97.1.23</doi><tpages>4</tpages></addata></record> |
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| ispartof | Chest, 1990-01, Vol.97 (1), p.23-26 |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Anticoagulants - therapeutic use Biological and medical sciences Cardiology. Vascular system Chronic cor pulmonale Diagnosis, Differential Female Follow-Up Studies Heart Humans Male Medical sciences Middle Aged Plethysmography, Impedance Pneumology Prospective Studies Pulmonary Embolism - diagnosis Pulmonary Embolism - diagnostic imaging Pulmonary Embolism - drug therapy Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases Radionuclide Imaging Thromboembolism - diagnosis |
| title | Clinical Validity of a Normal Perfusion Lung Scan in Patients with Suspected Pulmonary Embolism |
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