Pulmonary Embolism (as cause of Chest Pain)

If a PE causes pleuritic chest pain, it’ll also cause its cardinal symptom — dyspnea.  The dyspnea is usually experienced in sudden onset, within 30-60 seconds.  Sometimes the dyspnea is only noticed with exertion.

Suspect a PE based on risk factors:

Top Risk Factors for PE

  • Prior Hx of either PE or DVT !!!
  • Immobilization for >3 days.
  • Anesthesia within the last 4 weeks.
  • Active cancer
  • Maybe HIV infection
  • Maybe obese women who smoke & have hypertension

Clinical Findings Suggesting PE

  • Pain/tenderness in medial thigh (? DVT)
  • Leg redness, heat, swelling (? DVT)
  • Hemoptysis
  • Tachycardia (>100)
  • Tachypnea  (>20)
  • Loud S2 heart sound

If you think a PE is not unlikely, send the patient to an E.D.

See postings Acute Dyspnea – 2 and Chest Pain – 2.