Which of the following findings is the strongest predictive factor for pulmonary embolus?

A) Dyspnoea

B) Fever

C) Haemoptysis

D) Heart rate over 100 beats per minute

E) Known malignancy

The answer is D. PE can present in a multitude of ways and the Modified Wells score is useful for determining the likelihood of a PE:

Modified Wells:

• Clinical signs and symptoms of DVT +3
• Alternative diagnosis less likely than PE +3
• Heart rate over 100/min +1.5
• Immobilisation (>3 days) or surgery in previous 4 weeks +1.5
• Previous PE or DVT +1.5
• Haemoptysis +1.0
• Malignancy +1.0

A score of over 4 denotes that a PE is likely.