Pulmonary Embolism (Blood Clot in the Lung) - Diagnosis

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How is pulmonary embolism diagnosed?

There always needs to be a high a level of suspicion that a pulmonary embolus may be the cause of chest pain or shortness of breath. The healthcare professional will take a history of the chest pain, including its characteristics, its onset, and any associated symptoms that may direct the diagnosis to pulmonary embolism. It may include asking questions about risk factors for deep vein thrombosis.

Physical examination will concentrate initially on the heart and lungs, since chest pain and shortness of breath may also be the major complaints for heart attack, pneumonia, pneumothorax (collapsed lung), dissection of an aortic aneurysm, among other conditions.

With pulmonary embolism, the chest examination is often normal, but if there is some associated inflammation on the surface of the lung (the pleura), a rub may be heard (pleura inflammation may cause friction which can be heard with a stethoscope). The surfaces of the lung and the inside of the chest wall are covered by a membrane (the pleura) that is full of nerve endings. When the pleura becomes inflamed, as can occur in pulmonary embolus, a sharp pain can result that is worsened by breathing, so-called pleurisy or pleuritic chest pain.

The physical examination may include examining an extremity, looking for signs of a DVT, including warmth, redness, tenderness, and swelling.

It is important to note, however, that the signs associated with deep vein thrombosis may be completely absent even in the presence of a clot. Again, risk factors for clotting must be taken into consideration when making an assessment.

Return to Pulmonary Embolism (Blood Clot in the Lung)

See what others are saying

Comment from: QATaxman, 45-54 Male (Patient) Published: June 02

I went to the emergency room (ER) on advice from my physician for severe thoracic back pain and shortness of breath. A CT of the abdomen with and without contrast was ordered. They determined at that point I had a PE (pulmonary embolism). My symptoms had been going on for about 3 months now. The doctor I had seen, not my normal physician, determined I had a muscle problem, prescribed a muscle relaxer and a steroid, not once but twice. The third time in, I finally saw my physician with a UTI (urinary tract infection). He called me the next day to see how I was feeling. I was not feeling any better, and the back pain was unbearable now with shortness of breath. This is when I finally went to the ER.

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Comment from: David D, 25-34 Male (Patient) Published: September 29

I suddenly had shortness of breath, and a rapid heart rate. I called the ambulance and went to the local hospital. Upon entering I was put on a heart monitor, had an EKG, blood tests, and also a CT scan. The CT scan showed several large blood clots in my lungs (pulmonary embolism).

Was this comment helpful?Yes


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