Article1 August 1957THE VARIED CLINICAL MANIFESTATIONS OF PULMONARY EMBOLISMHAROLD L. ISRAEL, M.D., F.A.C.P., FRANZ GOLDSTEIN, M.D.HAROLD L. ISRAEL, M.D., F.A.C.P., FRANZ GOLDSTEIN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-47-2-202 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPulmonary embolism is a common finding at necropsy. It is nevertheless regarded in many hospitals as an unusual disorder, infrequently considered in the differential diagnosis of cardiopulmonary diseases.The frequent failure to recognize pulmonary embolism clinically can best be explained on the basis of widely held misconceptions regarding the prevalence of this disorder and the evidence necessary for its diagnosis.If the diagnosis is considered only when all the classic clinical and laboratory features are demonstrable, most instances of embolism will go unrecognized. Where physicians are familiar with the variety of clinical, radiologic and electrocardiographic manifestations which characterize pulmonary embolism,...Bibliography1. Belt TH: Thrombosis and pulmonary embolism, Am. J. Path. 10: 129, 1934. MedlineGoogle Scholar2. HamptonCastleman AOB: Correlation of post-mortem chest teleroentgenogram with autopsy findings (with special reference to pulmonary embolism and infarction), Am. J. Roentgenol. 43: 305-326, 1940. Google Scholar3. ZimmermanMillerMarshall LMDAN: Pulmonary embolism. Its incidence, significance and relation to antecedent vein diseases, Surg., Gynec. and Obst. 88: 373, 1949. MedlineGoogle Scholar4. Short DS: A survey of pulmonary embolism in a general hospital, Brit. M. J. 1: 790, 1952. CrossrefMedlineGoogle Scholar5. Collins DC: Pulmonary embolism, based on a study of 271 instances, Am. J. Surg. 33: 210, 1936. CrossrefGoogle Scholar6. McCartney JS: Post-operative pulmonary embolism, Surgery 17: 191, 1945. Google Scholar7. DeBakey ME: A critical evaluation of the problem of thromboembolism, Surg., Gynec. and Obst. 98: 1, 1954. MedlineGoogle Scholar8. IsraelPocock HLD: Pulmonary embolism: a major diagnostic problem, J. Philadelphia Gen. Hosp. 3: 47, 1952. Google Scholar9. RoeGoldthwaite BBJC: Pulmonary embolism: a statistical study of postmortem material at the Massachusetts General Hospital, New England J. Med. 241: 679, 1949. CrossrefMedlineGoogle Scholar10. Moran TJ: Pulmonary embolism in non-surgical patients with prostatic thrombosis, Am. J. Clin. Path. 17: 205, 1947. CrossrefMedlineGoogle Scholar11. Towbin A: Pulmonary embolism. Incidence and significance, J. A. M. A. 156: 209, 1954. CrossrefMedlineGoogle Scholar12. Bauer G: Nine years' experience with heparin in acute venous thrombosis, Angiology 1: 161, 1950. CrossrefMedlineGoogle Scholar13. Kirby CK: Venous thrombosis and pulmonary embolism, S. Clin. North America 26: 1389, 1946. MedlineGoogle Scholar14. KirbyFitts CKWT: Thromboembolic complications in surgical patients, Surgery 27: 564, 1950. Google Scholar15. EvansDee JAJF: Anticoagulant treatment of postoperative venous thrombosis and pulmonary embolism, New England J. Med. 238: 1, 1948. CrossrefGoogle Scholar16. FarmerSmithwick DARH: Thromboembolic disease: a discussion of the problem in surgical patients with particular reference to the fatal embolus, Angiology 1: 291, 1950. CrossrefMedlineGoogle Scholar17. AllenBarkerHines EVNWEA: Peripheral vascular diseases, 1946, W. B. Saunders Co., Philadelphia. Google Scholar18. Wolf L: Pulmonary embolism, Circulation 6: 768, 1952. CrossrefMedlineGoogle Scholar19. LillieBuxtonDuff RHRWIF: Prevention and management of thromboembolism, Arch. Surg. 59: 609, 1949. CrossrefMedlineGoogle Scholar20. CarlottiHardyLintonWhite JIBRRPD: Pulmonary embolism in medical patients, J. A. M. A. 134: 1447, 1947. CrossrefMedlineGoogle Scholar21. Vander VeerKuoMarshall JBPTDS: Experiences with venous thrombosis and pulmonary embolism, with special reference to anticoagulant therapy, Am. J. M. Sc. 219: 117, 1950. CrossrefMedlineGoogle Scholar22. BakerWarrenHomansLittman DVRJD: Pulmonary embolism: evaluation of a policy for prophylaxis and therapy, New England J. Med. 242: 293, 1950. CrossrefGoogle Scholar23. AnlyanShingletonDeLaughter WGWWGD: Significance of idiopathic venous thrombosis and hidden cancer, J. A. M. A. 161: 964, 1956. CrossrefMedlineGoogle Scholar24. PerkinsBradshaw RBHH: Pulmonary infarction mistaken for bronchogenic carcinoma, J. A. M. A. 151: 545, 1953. MedlineGoogle Scholar25. HusseyKatz HS: Pulmonary embolism, GP 12: 59, 1955. MedlineGoogle Scholar26. HarveySabiston JCDC: Empyema as a complication of bland pulmonary infarction: consideration of the problem and report of five cases, Ann. Int. Med. 40: 285, 1954. LinkGoogle Scholar27. OwenThomasCastlemanBland WRWABEF: Unrecognized emboli to the lungs with subsequent cor pulmonale, New England J. Med. 249: 919, 1953. CrossrefMedlineGoogle Scholar28. OstrowSteinbergTicktinPolisEvans BHDHEGNJM: Serum glutamic-oxalacetic transaminase in coronary artery disease, Circulation 14: 790, 1956. CrossrefMedlineGoogle Scholar29. Robertson CK: Points of local chest tenderness in post-operative pulmonary embolism, Edinburgh M. J. 56: 160, 1949. MedlineGoogle Scholar30. Loring WE: Venous thrombosis in the upper extremities as a complication of myocardial failure, Am. J. Med. 12: 397, 1952. CrossrefMedlineGoogle Scholar31. Tomlin EE: Pulmonary infarction complicating thrombophlebitis of the upper extremity, Am. J. Med. 12: 411, 1952. CrossrefMedlineGoogle Scholar32. KrauseSilverblatt SM: Pulmonary embolism, Arch. Int. Med. 96: 19, 1955. CrossrefGoogle Scholar33. PhillipsLevine EHD: A critical evaluation of extremity and precordial electrocardiography in acute cor pulmonale, Am. Heart J. 39: 205, 1950. CrossrefMedlineGoogle Scholar34. ZuckermannRodriguezSodi-PallaresBisteni RMIDA: Electropathology of acute cor pulmonale, Am. Heart J. 40: 805, 1950. CrossrefMedlineGoogle Scholar35. DackMasterHornGrishmanField SAMHALE: Acute coronary insufficiency due to pulmonary embolism, Am. J. Med. 7: 464, 1949. CrossrefMedlineGoogle Scholar36. DackGrishman SA: Pulmonary embolism and infarction, in Clinical cardiopulmonary physiology, edited by B. L. Gordon, 1957, Grune and Stratton, New York. Google Scholar37. BurchellPruittBarnes HBRDAR: The stress and the electrocardiograms in the induced hypoxemia test for coronary insufficiency, Am. Heart J. 36: 373, 1948. CrossrefMedlineGoogle Scholar38. KlakegParkin CHTW: Elevation of the RS-T segment in the precordial electrocardiogram and ventricular extrasystoles after exercise. Report of a case, Proc. Staff Meet., Mayo Clin. 29: 97, 1954. MedlineGoogle Scholar39. GoldsteinIsraelSeligson FHLD: Use of serum transaminase levels in the differentiation of pulmonary embolism and myocardial infarction, New England J. Med. 254: 746, 1956. CrossrefMedlineGoogle Scholar40. AgressGlassnerJacobs CMHFHI: Serum transaminase levels in experimental pulmonary infarction, Circul. Res. 4: 220, 1956. CrossrefMedlineGoogle Scholar41. LaDueWróblewskiNydick JSFI: Serum glutamic oxaloacetic transaminase activity as an index of acute myocardial damage, Mod. Concepts Cardiovas. Dis. 25: 333, 1956. MedlineGoogle Scholar42. McCann JC: Thromboembolism. A comparison of the effect of early postoperative ambulation and Dicumarol on its incidence, New England J. Med. 242: 203, 1950. CrossrefMedlineGoogle Scholar43. WilkinsStanton RWJR: Elastic stockings in the prevention of pulmonary embolism. II. A progress report, New England J. Med. 248: 1087, 1953. CrossrefMedlineGoogle Scholar44. Crane C: Deep venous thrombosis as the result of effort, New England J. Med. 246: 529, 1952. CrossrefMedlineGoogle Scholar45. Homans J: Thrombosis of deep leg veins due to prolonged sitting, New England J. Med. 250: 148, 1954. CrossrefMedlineGoogle Scholar46. Israel HL: The diagnosis of pulmonary embolism. Advances in medicine and surgery, from the Graduate School of Medicine of the University of Pennsylvania, 1952, W. B. Saunders Company, Philadelphia. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pennsylvania*Presented at the Thirty-eighth Annual Session of The American College of Physicians, Boston, Massachusetts, April 8, 1957.From the Department of Medicine, Graduate Hospital, University of Pennsylvania, Philadelphia.†Teaching and Research Fellow of the American Trudeau Society.Requests for reprints should be addressed to Harold L. Israel, M.D., 304 South Nineteenth Street, Philadelphia 3, Pennsylvania. 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