A 64-yr -old woman is referred to the medical team from the orthopaedic ward. She underwent a right total hip replacement 6 days ago. She is known to suffer from mild chronic obstructive pulmonary disease and is on regular inhaled steroids and a short-acting β2-agonist.
She now complains of left-sided chest pain and is also dyspnoeic.
Your clinical Dx is pulmonary embolism.
Which one of the following would not be a feature of pulmonary embolism in this pt?
A. Dyspnoea
B. Tachypnoea
C. New-onset atrial fibrillation
D. Fever
E. Bradycardia
Answer:
E) Bradycardia
Discussion:
Clinical features of pulmonary embolism are:
- Tachypnoea (respiratory rate > 20/min) – the commonest feature, occurring in 85% of pts
- Fever – a frequent finding, occurring in 34–50% of pts.
- Tachycardia – occurs in 30% of pts.
- Atrial flutter, atrial fibrillation and premature beats can also occur.
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