Reference 4
Symptom Percent of patients
with confirmed PE
Shortness of breath 80%
Pleuritic chest pain 52%
Cough 20%
Passing out (syncope) 19%
Chest pain (substernal) 12%
Coughing up blood (hemoptysis) 11%
Reference 4
Physical exam finding Percent of patients
with confirmed PE
Rapid respiratory rate (≥ 20/min) 70%
Rapid heart rate (≥ 100/bpm) 52%
Symptoms of DVT
(see DVT diagnosis)
20%
Cyanosis
(bluish discoloration of skin
from lack of oxygen)
11%
Fever (> 101.3) 7%
Reference 4, 5
Finding/History Points
Signs and symptoms of DVT +3
Heart rate > 100 bpm +1.5
Recently immobilization or surgery (≤ 4 weeks) +1.5
Previous PE or DVT +1.5
Coughing up blood
(Hemoptysis)
+1
Cancer +1
Pulmonary embolism more likely than alternative diagnosis +3

Reference 4
Wells Score PE probability
< 2 Low probability
2 - 6 Intermediate probability
≥ 7 High probability
  • Reference [19]
Pulmonary Embolism Rule-Out Criteria
Age < 50 years
Initial heart rate < 100 beats/min
Initial oxygen saturation > 94% on room air
No unilateral leg swelling
No hemoptysis
No surgery or trauma within 4 weeks
No history of VTE
No estrogen use










  • * Provoked - recent surgery or transient, nonsurgical risk factor
  • Reference 7
provoked vs
unprovoked*
First vs
second
Bleeding risk
(see bleeding risk below)
Extended anticoagulation
recommended
provoked not specified any no
unprovoked first low or moderate yes
unprovoked first high no
unprovoked second low or moderate yes
unprovoked second high no
Active cancer - ACCP recommends extended anticoagulation in all patients with active cancer




Reference [6]
Type of VTE Recurrence rate in first year after treatment of initial VTE
(with no extended anticoagulation)
Provoked by surgery 1.0%
Provoked by nonsurgical
risk factor
5.8%
Unprovoked VTE 7.9%





Estimated effect over 5 years of treatment with anticoagulation (% are absolute changes)
Low bleeding risk* Intermediate bleeding risk* High bleeding risk*
First VTE provoked by surgery Recurrent VTE reduction ↓ 2.6% ↓ 2.6% ↓ 2.6%
Major bleeding increase ↑ 2.4% ↑ 4.9% ↑ 19.6%
First VTE provoked by a nonsurgical factor/
first unprovoked distal DVT
Recurrent VTE reduction ↓ 13.2% ↓ 13.2% ↓ 13.2%
Major bleeding increase ↑ 2.4% ↑ 4.9% ↑ 19.6%
First unprovoked proximal DVT or PE Recurrent VTE reduction ↓ 26.4% ↓ 26.4% ↓ 26.4%
Major bleeding increase ↑ 2.4% ↑ 4.9% ↑ 19.6%
Second unprovoked VTE Recurrent VTE reduction ↓ 39.6% ↓ 39.6% ↓ 39.6%
Major bleeding increase ↑ 2.4% ↑ 4.9% ↑ 19.6%