Cardiorespiratory signs

These are caused by the passage of the embolus into or through the heart chambers, and into the pulmonary or coronary circulation. They may present as:

- cardiac arrest (which adds further diagnostic confusion to possible GE due to the associated cerebral anoxia),

- transient cardiovascular collapse,

- pulmonary oedema,

- cardiac arrhythmias (various),

- sudden dyspnoea with anxiety and signs of acute cor pulmonale,

- a usually loud and continuous millwheel murmur with systolic reinforcement that is only heard in 10% of cases on precordial auscultation. An oesophageal stethoscope is thought to be more sensitive.

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