Pulmonary Embolism (PE) is a global problem and a leading cause of cardiovascular death in the western world and a major public health problem [1,2]. The diagnosis of PE remains a challenge because of the high variability in clinical presentation complex interplay between different organs. Patients can present with chest pain, dyspnoea, haemoptysis, syncope and hypoxaemia [3,4]. Diagnosis of a PE is confirmed in <25% of patients that are clinically suspicious and the radiological investigations are essential [5,6]. Despite the low relative incidence of the disease, there is a significant rise in the number of patients undergoing unnecessary computed tomography pulmonary angiograms (CTPA) to exclude a PE. Moreover, the CTPA is the most robust predictive evidence base for adverse clinical outcomes in patients with acute PE [7,8].In most centres, patients with a high clinical suspicion of PE undergo serum D-dimer assessment as a screening test and it has a value in ruling out PE [9,10]. Treatment is initiated on those with a positive D-dimer and continuation of treatment is determined by the outcome of the CTPA scan [9]. Measurement of serum D-dimer requires venipuncture and results are not immediate [9]. CTPA scans are associated with high cost and exposure to radiation and nephrotoxic contrasts, a worrying concept