Whenever, I find DVTs in patients, I usually ask about chest pain, SOB, etc. What do you guys do with pts who have newly diagnosed DVTs and then complain of vague CP. I usually don't pursue the PE diagnosis if the symptoms are short lived, migratory in location on the chest, or have been going on forever. However, if you have a DVT and even mention the word chest pain, a lot of my colleagues automatically scan the chest. What they have found has surprised me. For example, I had one pt tell me that she feels funny in the chest from time to time and occasionally she gets lightheaded, but the symptoms are self limited. CT demonstrated bilateral main pulmonary artery PEs. Another pt with a below knee DVT told me that she sometimes feels sharp CP but then it goes away. CT showed multiple bilateral PEs. Take into account that these are otherwise healthy subjects with stable VS and do not appear to be in distress. The chest symptoms are usually elicited during the history taking and not even volunteered by the pts themselves. I think, for the most part, management and outcomes really don't change with the identification of the PE but there is always the sense that a PE was "missed." What is your practice here?