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: 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).

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Comment from: Nev8, 45-54 Female (Patient) Published: January 14

Blood clots were discovered post myomectomy (extensive fibroid removal) surgery. Two days after the surgery, I failed to walk properly on two attempts. First was moving from the bed and walking to a side chair in the room. Immediately I became nauseous and sweated profusely, and started to black out. Second attempt at walking was next day but failed for similar reasons exhibited during first walking attempt. X-ray and CT scan were immediately done and showed presence of blood clots in both lungs. Several pieces of clots were identified, but described to me by my doctor, as being very small. I have since been put on a blood thinner treatment plan; enoxaparin 150 mg daily. At next meeting with my doctor, he will discuss additional steps to be implemented going forward.

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