What is the typical chest location of pain associated with a pulmonary embolism (PE)?

From the Guidelines

Pain from a pulmonary embolism is typically felt as pleuritic chest pain, which is usually located on the side of the chest where the affected lung is located, due to distal emboli causing pleural irritation. This type of pain is one of the most frequent presentations of pulmonary embolism (PE) 1. The pain is often sharp and stabbing, and may worsen with deep breathing, coughing, or movement. In some cases, the pain may be accompanied by shortness of breath, and can radiate to the shoulder, upper back, or upper abdomen on the affected side. According to the guidelines on diagnosis and management of acute pulmonary embolism by the European Society of Cardiology 1, pleuritic chest pain is a common presentation of PE, and is usually due to distal emboli causing pleural irritation. Some key characteristics of pulmonary embolism pain include:

• Sharp, stabbing chest pain
• Pain worsens with deep breathing, coughing, or movement
• Pain may radiate to the shoulder, upper back, or upper abdomen on the affected side
• Accompanied by shortness of breath
• Not related to exertion and doesn't improve with rest It's essential to note that pulmonary embolism can be life-threatening, and anyone experiencing sudden, unexplained chest pain, especially with difficulty breathing, should seek emergency medical attention immediately 1.

From the Research

Location of Pain in Pulmonary Embolism

The location of pain in pulmonary embolism (PE) can vary, but it is often characterized by:

• Chest pain, which can be sudden and severe 2, 3
• The pain can be pleuritic, meaning it worsens with deep breathing or coughing 4
• In some cases, the pain can be referred to other areas, such as the upper abdomen or flank 5
• The location of the pain does not necessarily correspond to the location of the embolism in the lung

Characteristics of Chest Pain in PE

The chest pain associated with PE can be:

• Sudden onset 2, 3
• Sharp or stabbing 3
• Worsening with deep breathing or coughing 4
• Accompanied by other symptoms such as shortness of breath, syncope, or hemoptysis 2, 3

Importance of Considering PE in Patients with Chest Pain

It is essential to consider PE in patients presenting with acute chest pain, as the condition can be life-threatening if left untreated 2, 3

• A thorough evaluation, including assessment of clinical probability, D-dimer testing, and chest imaging, is necessary to diagnose PE 2
• Early identification and treatment of PE can significantly improve patient outcomes 2, 3