From the Guidelines
Lung auscultation in pulmonary embolism (PE) typically shows normal breath sounds, which is one of the classic features of this condition. Despite the severity of PE, the lungs often sound clear on examination, creating a concerning disconnect between the patient's respiratory distress and the normal auscultatory findings. In some cases, you may hear localized wheezing, decreased breath sounds in the affected area, or a pleural friction rub if there is associated pleural inflammation. Occasionally, crackles might be present due to atelectasis or pulmonary infarction. This normal or near-normal lung examination despite significant hypoxemia and respiratory distress is an important clinical clue that should raise suspicion for PE, especially when combined with risk factors such as immobility, recent surgery, cancer, or hormonal therapy. The disconnect occurs because PE is primarily a vascular problem rather than an airway issue, affecting blood flow to lung tissue while leaving air passages relatively unaffected until later stages of the disease process 1.
Some key points to consider when evaluating lung auscultation in PE include:
- The presence of normal breath sounds does not rule out PE, as the condition can present with a wide range of clinical findings 1
- The use of clinical probability assessment can help guide the interpretation of diagnostic tests, such as ventilation/perfusion scans 1
- A high index of suspicion for PE is necessary, particularly in patients with risk factors or underlying conditions that increase the likelihood of thromboembolism 1
It is essential to note that the diagnosis of PE should be based on a combination of clinical evaluation, laboratory tests, and imaging studies, rather than relying solely on lung auscultation. By considering the entire clinical picture and using a systematic approach to diagnosis, clinicians can improve their ability to detect PE and provide timely and effective treatment.
From the Research
Lung Auscultation for Pulmonary Embolism
- The provided studies do not directly address what lung auscultation typically shows for pulmonary embolism 2, 3, 4, 5.
- The studies focus on the treatment and diagnosis of pulmonary embolism using methods such as CT pulmonary angiography, low-molecular-weight heparin, and unfractionated heparin 2, 3, 4, 5.
- There is no mention of lung auscultation findings in the provided studies, suggesting that this information may not be relevant to the diagnosis or treatment of pulmonary embolism as discussed in these studies 2, 3, 4, 5.
Diagnostic Methods
- CT pulmonary angiography is a common diagnostic method for pulmonary embolism, with studies examining its accuracy and safety 3, 5.
- The studies also discuss the use of low-molecular-weight heparin and unfractionated heparin in the treatment of pulmonary embolism, including their efficacy and potential complications 2, 4.
- However, lung auscultation is not mentioned as a diagnostic method in these studies, indicating a lack of evidence on its typical findings for pulmonary embolism 2, 3, 4, 5.