Abstract
The clinical findings in 35 patients with acute massive pulmonary embolism were related to the known hæmodynamic disturbance. Presenting symptoms included " collapse ", dyspnœa, circulatory arrest, and central chest pain. The principal abnormal findings were central cyanosis, sinus tachycardia, hypotension, elevated central venous pressure, and gallop rhythm. The electrocardiogram usually showed evidence of acute right-ventricular " strain ". The chest X-ray was frequently unhelpful. Clinical diagnosis was usually straightforward, but assessment of the degree of obstruction in the pulmonary vascular bed could be difficult, particularly in the presence of additional cardio-respiratory disease. The importance of urgent cardiac catheterisation and pulmonary arteriography was stressed.
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