Few diseases are as common, as potentially lethal, and yet as frequently unrecognized as pulmonary embolism. When pulmonary emboli have been carefully sought at postmortem examination, the incidence has been found to be in excess of 25%.1-3 At the Peter Bent Brigham Hospital, pulmonary embolism is one of the three most common causes of death.1 Yet, the correct premortem diagnosis is made in only about 50% of the cases. The number of deaths due to pulmonary embolism may be decreased by early recognition and prompt treatment, thus minimizing the risk of additional episodes of potentially lethal embolism.
Recognition of Pulmonary Embolism
The well-known difficulty in recognizing pulmonary embolism is, in part, due to the fact that it can present as four different clinical syndromes:
1. Pulmonary Infarction.—
Although pulmonary infarction is the most familiar manifestation of pulmonary embolism, it is one of the least frequent complications of embolism.