How to Diagnose

In diagnosing DVT (Deep Vein Thrombosis), your doctor will ask you some questions regarding your symptoms.
The doctor will also check for areas of discoloration, swelling, and tenderness. If the doctor isn't positive if you have had a blood clot, further testing will be suggested.

Duplex Ultrasound
A radiologist will place a wand-like device over an area of your body where the clot might be located. The wand sends sound waves into your body that bounce or echo the waves back to a computer which produces images of your blood vessels. A blood clot may be seen in the images. This test requires no radiation and is painless.

Blood Test (D dimer test)
A blood test is performed to see if you have an elevated blood level of a clot dissolving substance called D dimer. If D dimer is present, there is a good likelihood that a blood clot has developed. If D dimer is not present, it is unlikely that you have a blood clot.

Venography
A radioactive dye(contrast agent) is injected into the top of your foot or ankle. An X-ray is then taken that enables your doctor to see images of your veins in your legs and feet, so they can look for blood clots.

Magnetic Resonance Imaging (MRI)
An MRI can provide images of your veins that may show if a blood clot has formed. The test uses radio frequency waves and a strong magnetic field to create the images of your veins. MRI image testing does a good job of finding deep vein thrombosis(DVT) in the thigh and pelvis.

 


How is a pulmonary embolism (PE) diagnosed?

 

Diagnosing a pulmonary embolism can be difficult, especially with symptoms that are similar to heart and lung disease. Doctors will order a series of tests to determine if you have a pulmonary embolism (PE).


Blood Test (D dimer test)
A blood test is performed to see if you have an elevated blood level of a clot dissolving substance called D dimer. If D dimer is present, there is a good likelihood that a blood clot has developed. If D dimer is not present, it is unlikely that you have a blood clot.

Chest X-ray
An X-ray will show images of your heart and lungs. This X-ray will not diagnose a pulmonary embolism, but it can rule out other health issues that mimic a pulmonary embolism.

Computer Tomography Scans (CT Scans)
In testing for blood clots in your lungs, a dye will be injected into your arm. The dye enables the blood vessels to show up on X-ray images. A special machine, an X-ray tube, will rotate around you as your are lying down, and it will take multiple images from several angles. The CT scan is popular with doctors because it is quick and results are available soon after the scan. This scan does detect most cases of PE (Pulmonary Embolism).

V/Q Lung Scan
During this scan, a radioactive material will be given to you in the beginning to inhale. A camera that detects radioactive substances will then analyze the movement of air in your lungs. The second part of the scan, you will have a very small amount of radioactive material injected into your arm and images are then taken to analyze blood flow in the blood vessels and lungs. These results will enable doctors to provide a diagnosis of a pulmonary embolism.

Pulmonary Angiogram
This test allows doctors to see the blood flow in the arteries of your lungs. A catheter is inserted into a large vein, most of the time in the groin area, and then it is advanced(threaded) through the heart into the blood vessels of the lungs. A dye is injected into the blood vessels via the catheter. X-rays are taken to show the blood flow through the blood vessels into the lungs. Doctors will then look for a blood clot. If a blood clot is found, a doctor may decide to use the catheter to remove the clot or to deliver medicine to dissolve it.  The pulmonary angiogram is the most accurate test to diagnose a pulmonary embolism, but the test must be administered by a trained specialist. Sometimes doctors perform this test as a last resort due to the serious risks that can occur.
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