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Potentially life-threatening emergency
Pulmonary embolism - Pulmonary
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Potentially life-threatening emergency

Pulmonary embolism - Pulmonary

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Contributors: Paritosh Prasad MD, Susan Voci MD, Sumanth Rajagopal MD
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Synopsis

Pulmonary embolism : Cough, Cyanosis, Delirium, Oral contraceptives, Pleuritic chest pain, Syncope, Tachycardia, Unilateral leg swelling, Dyspnea, Hemoptysis, Limb pain, RR increased, Orthopnea
A pulmonary embolism (PE) is a blood clot that typically originates from thrombi in the deep venous system of the legs and travels to the lungs. It can also originate from deep pelvic veins, rectal veins, the inferior vena cava, the right heart, and the axillary veins. Approximately 10% of cases are fatal.

The clinical presentation depends upon the size, location, number and chronicity of emboli, and the patient's cardiorespiratory reserve. Features may include dyspnea and tachypnea, pleuritic chest pain, cough, hemoptysis, pleural effusion, pulmonary infiltrates, cyanosis, syncope, and, in some cases, sudden death (classically pulseless electrical activity [PEA] arrest).

Predisposing factors for PE include a history of venous thromboembolism, genetic predilection (Factor V Leiden, antithrombin III gene mutation, protein C or S deficiency, etc), cancer, trauma, surgery, pregnancy or oral contraceptive use, prolonged immobility, advanced age, obesity, and congestive heart failure. Specific etiologies described in the literature, although uncommon, include embolization of struts from inferior vena cava filter and use of polymethylmethacrylate medical cement in spine surgery.

There are often long-term recurrent risks of another thromboembolism after the first venous thromboembolism.

Codes

ICD10CM:
I26.09 – Other pulmonary embolism with acute cor pulmonale
I26.99 – Other pulmonary embolism without acute cor pulmonale

SNOMEDCT:
59282003 – Pulmonary embolism

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:01/03/2022
Last Updated:01/04/2022
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Potentially life-threatening emergency
Pulmonary embolism - Pulmonary
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Pulmonary embolism : Cough, Cyanosis, Delirium, Oral contraceptives, Pleuritic chest pain, Syncope, Tachycardia, Unilateral leg swelling, Dyspnea, Hemoptysis, Limb pain, RR increased, Orthopnea
Imaging Studies image of Pulmonary embolism
Frontal chest x-ray with no definite acute disease, most common finding on chest x-ray with pulmonary emboli.

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