clear this trouble - vanco

[ArchivalUser]

a patient has h/o diabetes, M.I three years back, recently travled for long journey of 22 hours by direct flight. as he arrived at NY airport, he develop sudden chest pain, SOB, dyspnea, chest pain, Tachypnea, what is next step in diagnosis?

1. V/Q ratio
2. chest xray
3. spiral CT
4. pulomary angiogram

[ArchivalUser]

V/Q
probability of PE is very high so no need to do CXR

[ArchivalUser]

Yes I also select the V/Q

[ArchivalUser]

333...spiral CT

[ArchivalUser]

can anyone tell me what are the indications for spiral CT in PE??

[ArchivalUser]

Hi vanco,

this is really confusing!!!! why I choose spiral CT scan is because this patient has h/o prior MI which can interfere with Va/Q scan.....(pulmonary edema)

But again some says...chest x ray should be done first to rule out other causes of respiratory problem....

what do you think, vanco?

[ArchivalUser]

111. V/Q
though the gold standard for diagnosis of PE is pulmonary angiogram. most clinicians will prefer V/Q because pulmonary angiogram is more invasive.

[ArchivalUser]

v/q scan but where IS EKG FOR MI

[ArchivalUser]

v/Q best to rule out PE

[ArchivalUser]

vanco what is the answer???