Abstract
Clinical findings were not sensitive indicators of the presence or resolution of pulmonary emboli. However, patients with massive pulmonary embolism who received urokinase tended to have more rapid resolution of dyspnea, ↑S 2 P, and gallop sounds (at 24 hours) and more complete resolution at 14 days than comparable heparin patients. The preinfusion electrocardiogram was abnormal in the great majority of patients. Rhythm disturbances were infrequent, but QRS and ST-T changes were present in the majority. The most frequent single finding was T-wave inversion. Much less frequent were those changes of classic acute cor pulmonale. The limitations of electrocardiographic changes, therefore, are related to the inverse relation of their frequency and specificity. Moreover, the electrocardiogram did not sensitively reflect the resolution of pulmonary emboli.
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