CARDIAC SEQUELAE OF EMBOLISM OF THE PULMONARY ARTERY

Abstract

A number of clinical observations have indicated that some of the serious consequences of embolism of the pulmonary artery are due to a deleterious effect on the heart and the coronary circulation. Extensive occlusion of the pulmonary circulation is usually followed by circulatory shock and an associated diminution in the cardiac output. The usual symptom complex of embolism of the pulmonary artery, which is characterized by marked dyspnea, cyanosis, tachypnea, substernal oppression, collapse of the peripheral circulation, apprehension, feeble pulse, profuse perspiration, ashen pallor and low blood pressure, is frequently indistinguishable from the clinical picture observed in coronary occlusion with myocardial infarction. This striking similarity in itself suggests the possibility that the syndrome of embolism of the pulmonary artery may actually result from a diminution of the coronary circulation and associated ischemia of the myocardium. The characteristic electrocardiogram in cases of embolism of the pulmonary artery is frequently identical with