The chest x-ray may show an ascending aorta that extends beyond the rim of calcification, or may show a widened mediastinum. Aortography will demonstrate the dissection. Back to Index. The pain of pulmonary embolism is usually pleuritic with smaller peripheral emboli, or generalized and substernal with a large central embolism. Often the pain begins as a generalized discomfort, progressing to pleuritic pain as infarction of lung occurs or as the embolus breaks up and moves peripherally.
Most patients complain of shortness of breath.
The typical findings of pulmonary embolism are tachycardia and tachypnea. Lung exam is usually normal, but rales or wheezes may occur. About a third of the time, the pulmonary component of the second heart sound is increased. Most patients will have some abnormality of the chest x-ray. About half will have an elevated diaphragm on the side of the embolism.