The diagnosis and treatment of pulmonary embolism engage the internist as few other diseases do, for many good reasons. Physicians often miss the diagnosis (1). The mortality rate for untreated pulmonary embolism is quite high (2, 3) and is much lower when the disorder is correctly treated (4). However, treatment-related bleeding carries a substantial fatality rate (5). Pulmonary angiography, still the definitive test, is inconvenient to do at night, and the sensitivity of noninvasive imaging tests is still too low to rule out disease when clinical suspicion is high (6).

The medical literature contains 2 lines of inquiry regarding the ...


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