Pulmonary embolism history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]

Synonyms and keywords: PE

Overview

Pulmonary embolism is frequently asymptomatic. Prospective Investigation Of Pulmonary Embolism Diagnosis Study (PIOPED) found the following symptoms in 97% of patients with angiographic proven PE

• Dyspnea
• Pleuritic chest pain
• Tachypnea

The absence of this triad reduces the clinical probability of PE. Symptoms or signs of lower extremity deep venous thrombosis (DVT) can also be present in the patient.

History & Symptoms

Three major clinical presentations:

1. Dyspnea with or without pleuritic chest pain and hemoptysis
2. Hemodynamic instability and syncope (associated with massive pulmonary embolism)
3. In the elderly, it may mimick as indolent pneumonia or heart failure.

Thus, the symptoms are highly variable, nonspecific, and common among patients with and without PE