CLINICAL PHARMACOLOGICAL FEATURES OF RATIONAL USE OF DRUGS IN THROMBOEMBOLIC SYNDROME

All pulmonary embolisms are small, physiologically insignificant, and asymptomatic. When symptoms are present, they are nonspecific and vary in frequency and intensity depending on the degree of pulmonary artery occlusion and the underlying heart and lung status. A second heart sound (S2) may be present due to an increase in the pulmonary component (P2), but is uncommon in acute PE because the increase in pulmonary artery pressure is modest. Wheezing or rales may occur, but these sounds are usually related to underlying medical conditions. In the presence of right ventricular failure, there is dilatation of the internal jugular veins and right ventricular distention, a gallop rhythm is heard (appearance of the third heart sound [S3]), and a murmur of tricuspid regurgitation may be heard.