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(Circulation. 2004;109:I-3.)
© 2004 American Heart Association, Inc.

Preface

Second Issue in Series

Gregory L. Moneta, MD, Guest Editor

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The second issue of this series of supplements on venous thromboembolic disease is centered on diagnostic approaches to patients with venous thromboembolism (VTE). VTE includes the related disorders of deep venous thrombosis (DVT) and pulmonary embolism (PE). VTE is prevalent, sometimes lethal in the short run and is a potential source of disability in the long run. Diagnosis of VTE with sufficiently high sensitivity and specificity is not possible using the clinical history and physical examination alone, so objective methods of diagnosis are required. In the past, plythesmographic and radionuclide-based techniques were commonly employed for diagnosis of VTE. Currently, however, diagnosis of DVT in most institutions is made on the basis of ultrasound evaluation of the lower extremity veins and the most common initial direct test for PE is contrast-enhanced computerized tomography (CT scan).

Reliance on ultrasound for diagnosis of DVT has resulted in a literal explosion in the demand for urgent testing for screening for possible DVT in patients with suggestive symptoms, and this has become the most frequent type of examination performed in most vascular laboratories. Not all patients are suited to technically satisfactory examinations, and only about 15% of such studies are positive for DVT. For these reasons, it is important to select patients for immediate ultrasound examination, to exclude DVT on the basis of reasonable criteria, and to have other options in mind when ultrasound evaluation is not adequate. Similar considerations apply for patients with possible PE. It is important for clinicians to understand the diagnostic . . . [Full Text of this Article]