One of my colleagues pts had edema feet HTN was being managed with meds suddenly presented to other with severe acute SOB with no ECG changes by the time the pt went to ER pt collapsed conclusion was missed diagnosis of DVT 

Allowing a d-dimer for gps makes it easier to refer the pt in time or start anticoagulation treatment by the time pt reaches the specialist 

It is a known fact that it can give lots of false + ve results 

Dear colleagues,

I found a a list of possible contraindications for diving - not complete, but long enough (in German, the List was published by colleague Dr. Gregor Dietze on http://www.tauchtauglichkeitsuntersuchungen.de/kontraindikationen/; I attemped a translation): 

RespiratoryAbsolute contraindications:acute lung diseases in generalacute respiratory infections, obstructive changesLung diseases with relevant respiratory insufficiencySpontaneous pneumothorax in history, pneumothorax with known cause after 3 monthsknown cavities, emphysema, cysts, bronchiectasissevere bronchial asthma with permanent medication of cortisone or bronchodilatorslung and pleural diseases with restriction (fibrosis, pneumoconiosis)Directly after surgical intervention of the lungRelative contraindications:Chronic obstructive pulmonary disease (COPD) with mild pulmonary function impairment.healed sarcoidosis (radiologically) with normal lung functionpneumothorax due to accident / barotrauma after 3 monthstreated lung injury or lung surgery, at the earliest 3 months postoperativelyBronchial asthma with normal lung function, or in attack-free interval, or only mild activityvery heavy nicotine use with suspected morphological changesCardiovascularAbsolute contraindications:Coronary artery disease with stable or unstable angina pectorisexisting cardiac symptoms after dilatation or bypass surgery, or abnormal ECGAfter a large myocardial infarction, continuing cardiac symptoms, or continuing increased cardio-vascular riskHeart failure or markedly impaired ventricular function on cardiac echo.Cardiac arrhythmias: Sick sinus syndrome, complex ventricular dysfunction, supraventricular dysfunction with loss of consciousness, conduction disorders with paroxysmal tachycardia, block patterns of grade II or higher , left bundle branch block patterns with underlying morphologic diseaseall valve diseases with hemodynamic relevanceafter valve replacement, impaired performance, relevant cardiac arrhythmias or impaired hemodynamicsknown aortic aneurysmatrial or ventricular septal defects with hemodynamic relevancepacemaker with overall impaired performance and depending on the pacemaker typeMyocarditis (at least also 6 months after symptoms cease)Pulmonary embolism, thereafter 3 monthsPulmonary hypertension, cor pulmonaleArterial hypertension permanently > 160/100 mmHgSymptomatic peripheral circulatory disordersDeep vein thrombosis, until full mobilizationopen leg ulcerRelative contraindications:Myocardial infarction or cardiac surgery after 12 months with no symptoms, unremarkable exercise ECG and good exercise capacity and ventricular function.Grade I valve disease or 12 months or older after valve replacement with normal hemodynamics and valve function (echo + long-term ECG)Atrial or ventricular septal defects without hemodynamically effective shunt (echo / TEE)Functionally patent foramen ovale with diving restrictions and recommendationsafter overall assessment cardiac arrhythmias like AV block II°b, extrasystoles, ventricular arrhythmias, left bundle branch block, normofrequency atrial fibrillationpacemaker depending on type and underlying diseasemyocarditis after 6 months if well healedPulmonary embolism after 3 months with good lung functionLeg vein thrombosis in healing up to 6 monthsAnticoagulation / blood thinning is not a contraindication for diving.ENTAbsolute contraindications:lack of or severely limited pressure equalizationperforation of the tympanic membrane or a tube in the ear, atelectasisacute and chronic inflammation of the auditory canal, middle ear, inner ear and tubeatresia or non-evaluability of the tympanic membrane in case of occlusion of the auditory canalpersistent tube dysfunction after successful surgery of the tympanic membraneextensive radical surgery of the middle ear and mastoidacute and chronic balance disorders at rest or light exertionnasal septal deformity with disturbed tubal functionInability to hold and seal the mouthpiece (e.g., stroke or jaw injury)Functionally limiting and relevant laryngeal diseasesacute dental diseasesRelative contraindications:mild ear canal irritation or changes after surgerygood tubal function after successful treatment of pressure equalization disorder, healing of tympanic membrane perforation, relevant scars, atrophic changes, tubal catarrh, after middle ear infection, surgery, etc.after operations of the nose, larynx or eardrum with good overall function from 3 months onwardshearing improving operations individuallychronic vestibular disorders only under severe stress, normal provocation test or absence of symptoms after vestibular disordersdeafness, severe hearing loss, tinnitus or after hearing lossLaryngeal diseases without functional impairment with complaintschronic dental diseases, insufficient fillings and dentures

Mental state

Absolute contraindications:repeated hyperventilation syndrome with clear disposition to recurrencepanic and anxiety disorder confirmed and also already with justified suspicion or unstable mental situationacute psychoses (schizophrenic or manic-depressive) of psychological or organic originacute aggressive statesacute depression or medication of antidepressants, suicide attemptsanorexia nervosa and bulemiaphysical or psychological addictions (drugs, medication, alcohol)Relative contraindications:one-time hyperventilation syndrome with a known triggerafter psychotic disorder of any kind with stable conditions and no need for medicationovercome depression without medication or suicide riskafter anorexia nervosa with reintegration and normal eating behaviorafter addictions from 12 months depending on the remaining organic or psychological damage.Internal organsAbsolute contraindications:decompensating metabolic diseases, all relevant inflammatory diseasesall acute diseases with danger of collapseacute diarrhea or symptomatic colitisflorid ulcer, or after multiple gastrointestinal bleedingsacute anemia of unclear origin, thallasemia major in generaldiabetes mellitus 1 and 2 with poor control, hypoglycemia in the last 2 yearsknown intestinal obstruction in history, operationssevere flatulence or other intestinal gasinguinal hernia not reducible or painfulacute symptomatic stone disease, ureteral stones in generalprostate disease with recurrent urinary retentionclear renal insufficiency, hemodialysisoperations without sufficient wound healinginadequately treated disorders of increased coagulation, cryoglobinemia in generalRelative contraindications:stable mild metabolic diseases without risk potentialall stable chronic diseases with good performanceAdiposits, severe overweight with high fat mass due to increased inert gas accumulation !clear micturition disorders of any kindknown urological malformations even with good function, symptom-free kidney stones, after kidney transplantationrenal insufficiency (KreaClearance > 20) and good functionnon-symptomatic inguinal hernias, or after surgeryintestinal obstruction with adhesiolysis and absence of symptomsat most mild flatulence or other intestinal gashealed or treated ulcer disease without symptomsknown diabetes mellitus in experienced and disciplined sport divers with reliable and good adjustment, known signal signs of hypoglycemiasurgery with sufficient healing and good performanceknown acute anemia with good performanceMusculoskeletal system - Traumatology - OrthopedicsAbsolute contraindications:Degenerative, inflammatory or post-traumatic changes without sufficient self-control, efficiency or coordinationinsufficient self-controlled swimming ability or breathing safetyrehabilitation phase after operations or repositions, orthoseschest deformities with limited lung function ( < 70% )acute bone necrosis of any kindRelative contraindications:assured independence or experienced and assistive companionship, overall sufficient performance with assistive devicesrecurrent or habitual dislocations with persistent instabilitycompleted rehabilitation after trauma or surgerysignificant thoracic deformities without restriction of lung functionsubacute bone necrosis and absence of symptomsEyesAbsolute contraindications:angle-closure glaucoma or traumatic narrow-angle glaucoma after known glaucoma attackintraocular surgery (e.g. cataract) up to 1 monthcorneal operations 3-12 months depending on type of operationsevere ocular vascular diseases or after ocular hemorrhagesignificant visual field limitations e.g. after loss of one eye 4 months due to missing stereopsisnot compensated or corrected hyperopia > 4 dioptersRelative contraindications:unhealed ocular inflammationprimary open angle glaucoma also with functional impairmentknown narrow but asymptomatic chamber angleintraocular surgery (e.g. cataract) up to 3 monthsvisual field loss > 80% horizontal and > 50% vertical depending on underlying disease, diving candidates first in handicapped divingloss of one eye 4-12 months due to development of pseudostereopsis, experienced diving partnerlimited visual acuity < 0,5, possibly lower depending on instrumentsContact lenses, soft ones recommended because of better adhesionVariousAbsolute contraindications:mind-altering medication such as antidepressants, cytostatics or also Lariam with dizziness symptomsPregnancy (even without reliable evidence of a risk)Relative contraindications:Skin diseases e.g. eczema or cold urticaria or with risk of infectionafter pregnancy 4-6 weeks, 6-10 weeks after sectioexternal bowel outlet with good independent care - self-interest and actually also no contraindicationperformance-limiting medicationanticoagulation or risk of bleedingBoastful fearlessness, presentation without diving licenseFear with diving reluctance