Pulmonary embolism history & symptoms
|
Pulmonary embolism Microchapters |
|
Diagnosis |
|---|
|
History and Symptoms |
|
Treatment |
|
Follow-Up |
|
Special Scenario |
|
Trials |
|
Case Studies |
|
Pulmonary embolism history & symptoms On the Web |
|
Directions to Hospitals Treating Pulmonary embolism history & symptoms |
|
Risk calculators and risk factors for Pulmonary embolism history & symptoms |
Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], The APEX Trial Investigators; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
The symptoms of pulmonary embolism (PE) depends on the severity of the disease. A Pulmonary embolism may be an incidental finding in so far as many patients are asymptomatic.[1][2] The common symptoms of PE range from mild dyspnea, chest pain, and tachypnea, to sustained hypotension and shock.[3][2] The absence of these symptoms may be associated with a reduced clinical probability of pulmonary embolism, however it does not exclude the diagnosis of pulmonary embolism. The symptoms of lower extremity deep venous thrombosis may also be present.
History and Symptoms
Common Symptoms[4][5]
- Acute onset of exertional dyspnea or dyspnea at rest.
- Pleuritic or substernal chest pain.[3][6][7]
- Hemoptysis secondary to distal vessel embolism with subsequent pulmonary infarction (alveolar hemorrhage).[8]
- Circulatory collapse with subsequent syncope, sustained hypotension, and shock are associated with a massive pulmonary embolism.[9][2]
- Progressively worsening dyspnea can appear in patients with pre-existing pneumonia or heart failure.
Supportive Trial Data
The Prospective Investigation Of Pulmonary Embolism Diagnosis II (PIOPED II) study identified the following triad of symptoms present in a majority of patients with a confirmed pulmonary embolism.[3][10]
ESC 2008 Guideline Recommendation- Suspected High-risk PE (DO NOT EDIT)[11]
| Class I |
| "1. In high-risk PE, as indicated by the presence of shock or hypotension, emergency CT or bedside echocardiography is recommended for diagnostic purposes. (Level of Evidence: C) " |
References
- ↑ Stein PD, Matta F, Musani MH, Diaczok B (May 2010). "Silent pulmonary embolism in patients with deep venous thrombosis: a systematic review". The American Journal of Medicine 123 (5): 426–31. doi:10.1016/j.amjmed.2009.09.037. PMID 20399319. Retrieved on 2012-04-26.
- ↑ 2.0 2.1 2.2 Agnelli G, Becattini C (July 2010). "Acute pulmonary embolism". The New England Journal of Medicine 363 (3): 266–74. doi:10.1056/NEJMra0907731. PMID 20592294. Retrieved on 2012-04-26.
- ↑ 3.0 3.1 3.2 Stein PD, Beemath A, Matta F, Weg JG, Yusen RD, Hales CA, Hull RD, Leeper KV, Sostman HD, Tapson VF, Buckley JD, Gottschalk A, Goodman LR, Wakefied TW, Woodard PK (October 2007). "Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II". The American Journal of Medicine 120 (10): 871–9. doi:10.1016/j.amjmed.2007.03.024. PMID 17904458. Retrieved on 2012-04-26.
- ↑ Wells PS, Ginsberg JS, Anderson DR, Kearon C, Gent M, Turpie AG, Bormanis J, Weitz J, Chamberlain M, Bowie D, Barnes D, Hirsh J (December 1998). "Use of a clinical model for safe management of patients with suspected pulmonary embolism". Annals of Internal Medicine 129 (12): 997–1005. PMID 9867786. Retrieved on 2012-04-26.
- ↑ Miniati M, Prediletto R, Formichi B, Marini C, Di Ricco G, Tonelli L, Allescia G, Pistolesi M (March 1999). "Accuracy of clinical assessment in the diagnosis of pulmonary embolism". American Journal of Respiratory and Critical Care Medicine 159 (3): 864–71. PMID 10051264. Retrieved on 2012-04-26.
- ↑ Hull RD, Raskob GE, Carter CJ, Coates G, Gill GJ, Sackett DL et al. (1988). "Pulmonary embolism in outpatients with pleuritic chest pain.". Arch Intern Med 148 (4): 838-44. PMID 3355304.
- ↑ Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT et al. (1991). "Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease.". Chest 100 (3): 598-603. PMID 1909617.
- ↑ Stein PD, Henry JW (October 1997). "Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes". Chest 112 (4): 974–9. PMID 9377961. Retrieved on 2012-04-26.
- ↑ Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, Jenkins JS, Kline JA, Michaels AD, Thistlethwaite P, Vedantham S, White RJ, Zierler BK (April 2011). "Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association". Circulation 123 (16): 1788–830. doi:10.1161/CIR.0b013e318214914f. PMID 21422387. Retrieved on 2012-04-26.
- ↑ Stein PD, Fowler SE, Goodman LR, Gottschalk A, Hales CA, Hull RD, Leeper KV, Popovich J, Quinn DA, Sos TA, Sostman HD, Tapson VF, Wakefield TW, Weg JG, Woodard PK (June 2006). "Multidetector computed tomography for acute pulmonary embolism". The New England Journal of Medicine 354 (22): 2317–27. doi:10.1056/NEJMoa052367. PMID 16738268. Retrieved on 2012-04-26.
- ↑ Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U, Klepetko W, Mayer E, Remy-Jardin M, Bassand JP (September 2008). "Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)". European Heart Journal 29 (18): 2276–315. doi:10.1093/eurheartj/ehn310. PMID 18757870. Retrieved on 2012-04-26.
Table of Contents In Alphabetical Order | By Individual Diseases | Signs and Symptoms | Physical Examination | Lab Tests | Drugs
Editor Tools Become an Editor | Editors Help Menu | Create a Page | Edit a Page | Upload a Picture or File | Printable version | Permanent link | Maintain Pages | What Pages Link HereThere is no pharmaceutical or device industry support for this site and we need your viewer supported Donations | Editorial Board | Governance | Licensing | Disclaimers | Avoid Plagiarism | Policies
