Which physical findings suggest pulmonary venous thromboembolism (VTE)?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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Some patients have signs of DVT, lower-extremity swelling, and tenderness and warmth to touch. Clinical signs of pulmonary thromboembolism also include the following:

  • Tachypnea (respiratory rate exceeding 18 breaths/min) is the most common sign of PE
  • Tachycardia often is present
  • The second heart sound can be accentuated
  • Fever may be present
  • Lung examination findings frequently are normal
  • Cyanosis may be present

In the appropriate clinical setting, when shortness of breath, hypoxemia, and tachycardia are present, there should be a high clinical suspicion of PE until it is ruled out. Timely anticoagulation is important; 5-7% of recurrences are fatal.

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