Henry Ford Hospital Medical Journal


Clinical findings of 112 patients with angiographically proven pulmonary embolism over a five-year period were analyzed. Recent immobilization, chronic heart disease, deep venous thrombosis, malignancy, and recent surgery were the most frequent predisposing factors. Only 5% had no identifiable risk factors. Presenting syndromes were circulatory collapse (25%), pulmonary infarction (59%), and uncomplicated pulmonary embolism (18%). Dyspnea and pleuritic chest pain were the predominant symptoms. The combination of dyspnea, pleuritic chest pain, and hemoptysis occurred in 23% of the patients. The most frequent signs were tachypnea, tachycardia, and rales. Most of the patients demonstrated arterial oxygen tension (PaO2) between 50 and 70 mm Hg, and 9% had a PaO2 greater than 80 mm Hg. The most common chest x-ray findings were infiltration and consolidation, pleural effusion, and atelectasis. The most common electrocardiographic abnormalities were nonspecific ST and T-wave changes in 42% of patients. Lung scans were most frequently interpreted as indeterminate probability. A continuing reassessment of the features of pulmonary embolism may assist in selecting patients for confirmatory diagnostic studies.