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Pulmonary embolus

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Venous thrombo-embolism; Lung blood clot; Blood clot - lung; Embolus; Tumor embolus

Symptoms:

Symptoms of pulmonary embolism may be vague, or they may resemble symptoms associated with other diseases. Symptoms can include:

• Cough
  • Begins suddenly
  • May produce bloody sputum (significant amounts of visible blood or lightly blood streaked sputum)
• Sudden onset of shortness of breath at rest or with exertion
• Splinting of ribs with breathing (bending over or holding the chest)
• Chest pain
  • Under the breastbone or on one side
  • Especially sharp or stabbing; also may be burning, aching or dull, heavy sensation
  • May be worsened by breathing deeply, coughing, eating, bending, or stooping
• Rapid breathing
• Rapid heart rate (tachycardia)

Additional symptoms that may be associated with this disease:

• Wheezing
• Clammy skin
• Bluish skin discoloration
• Nasal flaring
• Pelvis pain
• Leg pain in one or both legs
• Swelling in the legs (lower extremities)
• Lump associated with a vein near the surface of the body (superficial vein), may be painful
• Low blood pressure
• Weak or absent pulse
• Lightheadedness or fainting
• Dizziness
• Sweating
• Anxiety

Signs and tests:

Tests to evaluate the function of the lungs:

• Arterial blood gases
• Pulse oximetry

Tests to detect the location and extent of embolism :

• Chest x-ray
• Pulmonary ventilation/perfusion scan
• Pulmonary angiogram
• CT angiogram of the chest

Tests to detect DVT:

• Doppler ultrasound exam of an extremity blood flow studies
• Venography of the legs
• Plethysmography of the legs

An ECG may show abnormalities caused by strain on the heart.

This disease may also alter the results of the following tests:

• Echocardiogram
• D-dimer level
• Chest CT scan
• Chest MRI scan

References:

Perrier A, Roy PM, Aujesky D, et al. Diagnosing pulmonary embolism in outpatients with clinical assessment, D-Dimer measurement, venous ultrasound, and helical computed tomography: a multicenter management study. Am J Med . March 2004;116:291-299.

Ramzi DW, Leeper KV. DVT and Pulmonary Embolism: Part II. Treatment and Prevention. Am Fam Physician . June 15 2004;69:2841-2848.

Merli G. Diagnostic assessment of deep vein thrombosis and pulmonary embolism. Am J Med . August 2005;118:3S-12S.

• Review Date: 3/1/2007
• Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.

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