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Pulmonary Embolism

 Syn. PE , lung embolism , Pulmonary embolus

Signs & Symptoms

 Unexplained breathlessness
Ref: Harrison [ 1910]
Breathlessness
Ref: Harrison [ 1910]
Feeling of apprehension
Ref: Epocrates [ https://online.epocrates.com/diseases/11632/Pulmonary-embolism/Risk-Factors]
Widened alveolar-arterial gradient for oxygen
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism] Cecil [ 166]

Physical Examination

 Hypoxemia
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism] Cecil [ 166]
chest-wall pain exacerbated by certain movements of the chest (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/11635/Pulmonary-embolism/Differential-Diagnosis]
Palpable cords
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism]

Lab / Serology

 Increased D-dimer
Ref: Uptodate [ Overview of the causes of venous thrombosis] Harrison [ 1912] Cecil [ 166]
Hypercoagulable state
Ref: Uptodate [ Overview of the causes of venous thrombosis]
elevated cardiac biomarkers (negative symptom)
Ref: Epocrates [ https://online.epocrates.com/diseases/11635/Pulmonary-embolism/Differential-Diagnosis]

Imagin Study

 Tachycardia on ECG
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism] Harrison [ 1912] Cecil [ 166]
ST-segment changes
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism]
T-wave changes
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism] Harrison [ 1912]

Complication

 Elevated central venous pressure
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism]
Acute right ventricular failure
Note: In Massive PE
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism]
Right-sided third heart sound
Note: In Massive PE
Ref: Uptodate [ Clinical presentation, evaluation, and diagnosis of the nonpregnant adult with suspected acute pulmonary embolism]

Risk Factors

 Elder
Ref: Uptodate [ Overview of the causes of venous thrombosis]
Male
Ref: Uptodate [ Overview of acute pulmonary embolism in adults]
Winter season
Ref: Uptodate [ Overview of the causes of venous thrombosis]

Cause

 Hypercoagulable state
Ref: Uptodate [ Overview of the causes of venous thrombosis]
Immobilization Gr. Male
Ref: Uptodate [ Overview of the causes of venous thrombosis]

Other