0071643192.pdf

CARDIOVASCULAR EMERGENCIES

TABLE 2.31. Wells Clinical Prediction Rule for PE

CLINICALFEATURE POINTS

Clinical symptoms of DVT 3

Other diagnosis less likely than PE 3

Heart rate >100 bpm 1.5

Immobilization or surgery within past 4 weeks 1.5

Previous DVT or PE 1.5

Hemoptysis 1

Malignancy 1

High risk for PE: >6 points

Moderate risk for PE: 2—6 points

Low risk for PE: <2 points

Note: Newer studies are dichotomizing patients into low

(≤4 points) or high (>4 points) risk.

FIGURE 2.22. Contrast-enhanced helical chest CT, showing large filling defect in both
pulmonary arteries from a saddle pulmonary embolus.

(Courtesy of Matthew J. Fleishman, MD, Radiology Imaging Associates. Englewood, Colorado.)