Pulmonary embolism physical examination: Difference between revisions

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* Distended neck veins.
* Distended neck veins.
==Heart==
==Heart==
[[Parasternal heave]].
[[Parasternal heave]] may be present.
 
* Prominent second heart sound ([[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|P2]]).
* Prominent second heart sound ([[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|P2]]).
* Murmur of [[tricuspid regurgitation]].
* Murmur of [[tricuspid regurgitation]].

Revision as of 18:49, 24 April 2012

Pulmonary Embolism Microchapters

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Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]

Overview

The decision to do medical imaging is usually based on clinical grounds, i.e. the medical history, symptoms and findings on physical examination, followed by an assessment of clinical probability.

Appearance of the Patient

The patient may appear anxious because of difficulty in breathing. More severe cases may be associated with cyanosis (bluish discoloration, usually of lips and fingers).

Vital Signs

Temperature

Patient is generally afebrile.

Pulse

Rate

Tachycardia may be present

Rhythm

The pulse may be regular.

Strength

The pulse may be bounding and strong

Symmetry

The pulses may be symmetric.

Respiratory Rate

Tachypnea may be present.

  • Lowered SpO2 level on room air.

Blood Pressure

The patient is generally hypotensive.

Without immediate intervention it might lead to shock or even collapse. About 15% of all cases of sudden death are attributable to PE.

Skin

Cyanosis may be present depending upon the severity of PE.

Neck

Patients with Submassive PE present with signs of RV dysfunctions, which are as follows:

  • Distended neck veins.

Heart

Parasternal heave may be present.

However, these signs have poor sensitivity.

Thorough assessment should be made for the presence of a deep vein thrombosis.

References

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