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)
- 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.