This content is provided by StatPearls
Build quizzes with our comprehensive database in your specialty and track your progress. See your score history and get additional learning resources.Signup For Free Access!
A 55-year-old female undergoes a hip replacement after a fall. Two days post op she develops sudden shortness of breath and tachycardia. On examination, she is tachypneic with a heart rate of 120. Her blood pressure is 120/57. Blood gas reveals a pH of 7.38, PCO2 35, PO2 72, and bicarbonate of 23. Duplex of the extremities reveals a large clot in the iliofemoral veins. What of the following is most likely to be found on a chest radiograph?
Select Your Answer:
Teaching Points
- The chest x-ray of a patient with pulmonary embolism is most often normal. This is the reason that this examination must be followed by CT pulmonary artery angiography and ventilation-perfusion scan.
- Westmark sign describes the relative area of oligemia or paucity of pulmonary markings on a chest x-ray due to vasoconstriction. It is seen in less than 10% of patients.
- Hampton hump describes wedge-shaped opacity which is pleural-based with convex medial border representing pulmonary infarction. Pleural effusion accompanies pulmonary infarction in acute and subacute phases. It may be absent in the hyperacute phase or when infarction is close to resolving.
- If the patient has a history of contrast allergy, a V/Q scan can be substituted.
StatPearls Review Article:
Click here to become an author
*eMedicine, Google Scholar, UpToDate, WheelessOnline, and DermNet are not affiliated with StatPearls. We do not control their content or advertising.
Adult Lab Normals
Pediatric Lab Normals
Calculator
PubMed References
| EVAR-first strategy for ruptured aneurysm focuses on Fitzgerald classification and vein thrombosis., Murakami Y,Toya N,Fukushima S,Ito E,Akiba T,Ohki T,, Annals of vascular surgery, 2018 May 17 [PubMed] |
| Early discharge of patients with pulmonary embolism in daily clinical practice: A prospective observational study comparing clinical gestalt and clinical rules., Vanni S,Becattini C,Nazerian P,Bova C,Stefanone VT,Cimini LA,Viviani G,Caviglioli C,Sanna M,Pepe G,Grifoni S,, Thrombosis research, 2018 May 8 [PubMed] |
| Comparison of the serum metabolic signatures based on <sup>1</sup>H NMR between patients and a rat model of deep vein thrombosis., Cao J,Jin QQ,Wang GM,Dong HL,Feng YM,Tian JS,Yun KM,Wang YY,Sun JH,, Scientific reports, 2018 May 18 [PubMed] |
| Discrepancy Between Clinician Gestalt and Subjective Component of the Wells Score in the Evaluation of Pulmonary Embolism., Akhter M,Kline J,Kannan V,Courtney DM,Kabrhel C,, Annals of emergency medicine, 2018 Jun [PubMed] |
| [Vena Cava Filter Products Review]., Cui S,Zho Q,Liu Q,Zhao Q,Shi G,, Zhongguo yi liao qi xie za zhi = Chinese journal of medical instrumentation, 2016 May [PubMed] |
