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Pulmonary
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Diagnostic Strategy in Suspected PE
Flowchart
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Wells score → D-dimer or CTPA.
Decision
Outcome
Decision
Suspected PE — first scoring step?
✓
Apply modified Wells criteria
✗
Get a chest CT for every patient
Decision
Wells result?
✓
PE unlikely → D-dimer
✓
PE likely → CTPA
Decision
D-dimer result?
✓
≤500 ng/mL → PE excluded
✓
>500 ng/mL → CTPA
Outcome
PE excluded — pursue alternative diagnosis
Decision
CTPA result?
✓
Positive → PE confirmed
✓
Negative → PE excluded
Outcome
Treat PE per anticoagulation algorithm