Which symptoms are most characteristic of pulmonary embolism?

• A. Gradual onset cough with sputum production.
• B. Chest pain that worsens with inspiration but is not pleuritic.
• C. Acute dyspnea with pleuritic chest pain, tachycardia; may have hypoxia.
• D. Chest pain relieved by lying flat.

Answer: (C)

Pulmonary embolism most often shows up with sudden shortness of breath and chest pain that feels sharp and worsens with deep, rapid breathing because the embolus causes irritation of the pleura and creates a ventilation–perfusion mismatch in the lungs. The heart tends to beat faster as the body tries to compensate for reduced oxygen delivery, and low oxygen levels (hypoxemia) may develop. This combination—acute dyspnea, pleuritic chest pain, tachycardia, and possible hypoxemia—is the classic pattern for PE. The other scenarios fit better with infections (gradual cough with sputum), chest pain that isn’t pleuritic, or chest pain characteristics seen with other conditions, so they are less typical for a pulmonary embolism.