Because the symptoms of a pulmonary embolism overlap with many other medical conditions, it can be challenging to diagnose.
Your provider’s first step in diagnosing your heart condition is taking your history, followed by a physical exam. The purpose is to learn about your symptoms and overall health. During your visit, expect your provider to do the following:
- Discuss your medical history and current medical conditions.
- Examine your body, including your abdomen, eyes and ears, feet and ankles, neck, nose and mouth, and skin.
- Listen to your heart and lungs with a stethoscope.
- Check your blood pressure, heart rate and oxygen levels.
Blood tests, a common part of a medical exam, are tests that help doctors diagnose medical conditions. Blood tests can be used to check your overall health, and they can alert your doctor to changes occurring within your body.
During most blood tests, a healthcare provider inserts a needle into your arm at your elbow. The blood flows through the needle and into a tube, which is sealed and evaluated in a lab.
A blood test usually takes less than 15 minutes.
A CT angiogram, also called a CTA, is an imaging test that uses a CT scan and contrast dye to create detailed pictures of your blood vessels. This helps doctors see blockages, aneurysms or other problems inside arteries and veins throughout your body. During this test, you will lie on a table and an IV will be placed in your hand or arm. Contrast dye will be injected into the IV, and you will have painless electrodes attached to your chest. This will allow your medical team to monitor your heart rate and rhythm. The table slides into the CT machine, which takes a series of images from various angles. The procedure usually takes less than an hour.
A pulmonary ventilation/perfusion scan, also called a V/Q scan, measures airflow and blood flow in the lungs. This scan consists of two tests that can help a medical provider diagnose lung-related conditions, including pneumonia, chronic obstructive pulmonary disease (COPD) and a pulmonary embolism.
For the ventilation scan, you will sit or lie on a table under a scanner arm and breathe in radioactive gas through a mask. Both tests are evaluated using a chest X-ray, looking to see if the radioisotope is distributed evenly throughout the lungs.
For the perfusion portion of the scan, you will lie on a movable table and a medical provider will inject radioactive albumin into a vein. You may feel discomfort as the IV is placed. A nuclear imaging machine will then scan your lungs as blood flows into them, looking for radioactive particles.
The radiation involved in the scan leaves the body within a few days, and there is a minimal amount of risk for infection from the IV insertion.
A D-dimer test is a blood test used to detect the presence of a protein called D-dimer in your bloodstream. D-dimer is produced when a blood clot is being created or dissolved in the body. If you have high levels of D-dimer, it could mean that a blood clot or a blood-clotting disorder is present. A D-dimer test can help diagnose deep vein thrombosis, pulmonary embolism or other vascular conditions.
A duplex ultrasound uses sound waves to create images of your blood vessels. It combines traditional ultrasound for structure with a Doppler technique that shows blood flow. This allows doctors to assess blood flow speed and direction to diagnose blockages, narrowing or abnormal flow patterns. During the test, you’ll lie on a table. The technologist will place a gel over the tissues being examined and then move a transducer wand over the area. Sound waves from the wand bounce off the tissues and back to a computer, which interprets the waves to create images. The test is painless.
A vascular ultrasound is an imaging study that uses sound waves to create images of your blood vessels. This painless test helps doctors examine the arteries and veins and see blood flow patterns. During the test, you lie on a table and a gel is applied to your skin by a technologist. The technologist then presses a transducer wand on your skin, and the sound waves bounce off the areas being examined and are converted into images by a computer. A vascular ultrasound generally takes less than 45 minutes. It evaluates for abnormal blood flow, blockages and narrowing in the blood vessels that could indicate vascular disease.
Coronary angiography, also called a coronary angiogram, is a test that evaluates your coronary arteries to determine if a narrowing or blockage is present.
A coronary angiogram is performed in the cardiac catheterization lab. You will receive sedation to help you relax. Depending on your health and the reason for your angiogram, you may be awake or you may receive general anesthesia so you’re completely asleep.
Your provider makes a small incision in your groin or wrist. A catheter is then inserted into the incision. This flexible tube is guided to the heart, and then a special dye is released from the tube. The contrast dye spreads through your heart and blood vessels. X-ray pictures then highlight blocked arteries causing your symptoms.
If you have a blockage, your doctor may choose to treat it right away. This may be done by inflating a balloon on the end of the catheter to expand the artery and remove the blockage. During this procedure, known as angioplasty, a mesh tube called a stent is often placed to help the artery stay open.
Depending on your condition, you might be able to go home the same day as your coronary angiogram, or you might need to stay in the hospital longer.
An electrocardiogram (ECG) is a noninvasive test that records your heart’s electrical activity.
During an electrocardiogram, temporary electrodes will be placed on the chest to monitor and record electrical signals. A computer then translates those signals into a wave pattern, which a medical provider will interpret.
An electrocardiogram is a simple test that takes only minutes to perform in an inpatient or outpatient setting. Other forms of ECG track the heart’s rhythms for longer periods, including:
- An event monitor, worn for a week or longer
- A Holter monitor, worn for up to 48 hours
An echocardiogram (echo) uses ultrasound technology, or sound waves, to capture an image of your heart’s structure.
During the echocardiogram, your technologist will place a wand on the skin of your chest above your heart. Sound waves from the wand bounce off your heart, creating an image of your heart’s chambers and valves.
An echocardiogram is an outpatient test that takes less than an hour. You can return home as soon as the test is completed.
