From the Guidelines
Pulmonary embolism (PE) symptoms include unexplained shortness of breath, chest pain, tachycardia, apprehension or tachypnea, syncope, and hypoxemia, with the most common presenting symptoms being dyspnea, pain, and tachypnea, present in 85%, 40%, and 29% of patients with PE, respectively 1.
Symptoms of Pulmonary Embolism
The symptoms of PE can vary depending on the size of the clot and the amount of lung tissue affected. Some common symptoms include:
- Sudden shortness of breath
- Chest pain that worsens with deep breathing or coughing
- Rapid or irregular heartbeat
- Lightheadedness
- Coughing up blood
- Anxiety, sweating, or low-grade fever
Severity of Symptoms
The severity of symptoms depends on the size of the clot and how much lung tissue is affected. Large PEs can cause low blood pressure, fainting, or shock.
Risk Factors
Risk factors for PE include prolonged immobility, recent surgery, cancer, pregnancy, hormonal contraceptives, and genetic clotting disorders.
Importance of Prompt Treatment
If you experience these symptoms, especially with risk factors, seek emergency medical attention immediately as PE can be life-threatening without prompt treatment 1.
Diagnosis
The preferred imaging technique for the initial diagnosis of PE is CT angiography (CTA), which allows for indirect evaluation of pulmonary vessels and has several advantages, including accurate imaging of mediastinal and parenchymal structures, accurate visualization of emboli in many regions of the pulmonary vasculature, and ability to detect signs of right ventricular (RV) enlargement 1.
From the Research
Symptoms of Pulmonary Embolism (PE)
The symptoms of Pulmonary Embolism (PE) can vary, but common symptoms include:
- Sudden onset dyspnea (shortness of breath) 2, 3, 4, 5
- Chest pain 2, 6, 3, 4, 5
- Syncope (fainting) or near-syncope 2, 4, 5
- Hemoptysis (coughing up blood) 2, 6, 3, 4, 5
- Limb swelling 4
- Cough 6
- Pleuritic chest pain (chest pain that worsens with deep breathing) 3
Clinical Presentation
The clinical presentation of PE can range from asymptomatic cases to life-threatening events 4. The symptoms can vary based on thrombus burden, demographics, and time to presentation 4.
Diagnostic Evaluation
Diagnostic evaluation involves assessing symptoms, physical examination findings, and utilizing laboratory tests, including D-dimer 4. Basic investigations like arterial blood gas analysis, electrocardiogram, chest x-ray, and biochemical analyses are also appropriate 5. Lung ultrasound and echocardiography are indicated in many patients with suspected PE 5.
Risk Stratification
Risk stratification using tools like Wells score, Pulmonary Embolism Severity Index, and Hestia criteria aids in determining the severity of PE 4, 5. PE is categorized based on hemodynamic status, temporal patterns, and anatomic locations of emboli to guide treatment decisions 4.