[Diagnostic strategy of acute pulmonary embolism]

The clinical signs of acute pulmonary embolism do not have any diagnostic specificity; they only raise the suspicion of the diagnosis, which is confirmed by complementary investigations: pulmonary perfusion and ventilation scintigraphy, phlebography of the lower limbs and pulmonary angiography. Non invasive diagnostic tests are now preferred; echocardiography, Doppler ultrasound of the lower limbs, assay of D-dimers, helicoidal thoracic CT scan. Diagnostic decision trees are proposed on the basis of these data.