What are the clinical manifestations of pulmonary embolism?

The clinical manifestations of pulmonary embolism are very complex. In addition to cough and fever, it is also accompanied by dyspnea, chest pain, syncope, hemoptysis, etc. Pulmonary embolism is a relatively frequent and common disease. The common clinical manifestations of this disease are acute cardiopulmonary disease and pulmonary infarction. By understanding these symptoms, we will have a comprehensive understanding of pulmonary embolism.

The clinical manifestations of pulmonary embolism mainly include four syndromes: ① acute cor pulmonale; ② pulmonary infarction; ③ unexplained dyspnea; ④ chronic recurrent pulmonary thromboembolism.

The main symptoms of pulmonary embolism are:

① Dyspnea and shortness of breath (80%-90%) are the most common symptoms. Mild cases present with paroxysmal hyperventilation and shortness of breath after activity, while severe cases present with persistent dyspnea and shallow and rapid breathing, which may reach 40-50 times per minute.

② Chest pain, including pleuritic chest pain (40%-70%), manifested as chest pain aggravated by breathing and coughing, indicating small peripheral pulmonary vascular embolism or pulmonary infarction; or angina-like pain (4%-12%), manifested as asymmetric squeezing sensation behind the sternum, which may radiate to the shoulder blades and neck, indicating large vessel embolism causing acute pulmonary artery dilatation and coronary artery ischemia.

③ Syncope (11%-20%) is caused by cerebral ischemia due to a sharp decrease in cardiac output, indicating acute embolism of large vessels and may be the only or first symptom of pulmonary embolism.

④ Restlessness, panic, and even a sense of impending death (55%).

⑤ Hemoptysis (11%-30%), usually small amount of hemoptysis, large amount of hemoptysis is rare, bright red in color, turns dark red after a few days, indicating pulmonary infarction.

⑥ Cough (20%-37%).

⑦Palpitations (10%-18%). It should be noted that the so-called "triad of pulmonary infarction" (dyspnea, chest pain and hemoptysis) occurs in less than 30% of patients clinically.