Difficulties in diagnosing pulmonary embolism in the obese patient: a literature review

Vasc Med. 2011 Dec;16(6):444-51. doi: 10.1177/1358863X11422571. Epub 2011 Oct 24.


Several of the signs and symptoms of pulmonary embolism, such as dyspnea, tachypnea, and tachycardia, are common in the obese population, so these patients are frequently suspected of having a pulmonary embolism. Establishing an accurate diagnosis in this situation is often difficult. We performed a review of the literature examining the difficulty of diagnosing pulmonary embolism in obese patients. Several factors compromise the ability of clinicians to accurately diagnose pulmonary embolism in obese patients. When patients weigh over 350 lbs (159 kg), thoracic imaging often cannot be performed because of the weight limitations of the scanning equipment. If equipment is available that can scan these patients, image quality is often poor. The literature that is available to guide the clinician in this difficult clinical scenario is sparse. Access to radiology equipment that can image morbidly obese patients is improving, but questions about image quality remain. Further research on both imaging and outcomes is needed.

Publication types

  • Review

MeSH terms

  • Angiography
  • Contraindications
  • Diagnosis, Differential
  • Diagnostic Imaging*
  • Dyspnea / diagnosis
  • Dyspnea / physiopathology
  • Female
  • Humans
  • Male
  • Obesity / complications
  • Obesity / diagnosis*
  • Obesity / physiopathology
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis*
  • Pulmonary Embolism / physiopathology
  • Tachycardia / diagnosis
  • Tachycardia / physiopathology
  • Tachypnea / diagnosis
  • Tachypnea / physiopathology
  • Tomography, X-Ray Computed