Clinical features of massive PE
The symptoms of massive pulmonary embolism include:
- crushing chest pain
- sudden circulatory collapse - patient becomes pale, sweaty and breathless
- transient loss of consciousness
- haemoptysis is uncommon
The signs of massive pulmonary embolism include:
- central cyanosis
- feeble pulse
- tachycardia/bradycardia
- hypotension
- raised JVP
- auscultation of heart reveals:
- pulmonary hypertension (loud P2)
- a third or fourth heart sound (gallup rhythm)
Ventricular fibrillation may ensue.
Reference
- Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020 Jan 21;41(4):543-603.
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