What are the clinical manifestations of acute pulmonary thromboembolism?

The pain and adverse effects caused by major diseases are far-reaching. They can destroy people's confidence and in severe cases can make people feel pessimistic and suffer from depression. For example, acute pulmonary thromboembolism has common clinical manifestations including chest pain, cough, fever, sometimes coughing up blood, and can even cause sudden death. Understanding the basic knowledge of the disease will help everyone prevent and treat it.

What are the symptoms of pulmonary thromboembolism?

The clinical manifestations of PE are non-characteristic and depend on the extent of pulmonary vascular obstruction, the original cardiopulmonary function status, and whether pulmonary infarction develops. Small emboli are often asymptomatic, while massive emboli often cause acute right heart failure leading to syncope, shock, and even sudden death. Generally speaking, symptoms of embolism often appear suddenly within minutes, while symptoms of infarction take hours to appear. Symptoms often last for several days, depending on how quickly the clot dissolves and other factors, but they usually get better each day.

The most common symptoms of acute pulmonary embolism are shortness of breath and chest pain. 90% of PE patients may experience shortness of breath, rapid breathing, or chest pain. Syncope is uncommon but when it occurs it often indicates hemodynamic instability. More serious cases may result in shock, systemic hypotension, and even sudden death. Chest pain is a common symptom of PE. It is often caused by pulmonary infarction irritating the pleura. Pulmonary embolism with hemodynamic instability sometimes causes right heart myocardial ischemia, producing substernal pain similar to angina pectoris. Other symptoms of pulmonary infarction such as fever, cough, blood in sputum, or hemoptysis may occur.

Common signs of acute pulmonary embolism include tachypnea (>20 times/min), cyanosis, pulmonary rales, tachycardia, fourth heart sound, and increased pulmonary valve second heart sound. When PE is combined with shock, clinical signs such as systemic arterial hypotension, oliguria, cold extremities and/or acute right heart failure may occur. Fever (>38, 9°C) can also be seen in patients with PE. Some patients have signs of deep vein thrombosis.