Which symptom is most commonly associated with acute pulmonary embolism?

• A. Dyspnea at rest
• B. Productive cough
• C. Chest rash
• D. Abdominal pain

Answer: (A)

Acute pulmonary embolism most commonly presents with dyspnea. When a clot blocks part of the pulmonary circulation, it creates a sudden ventilation–perfusion mismatch and reduced oxygenation. The lungs respond by increasing the respiratory drive, so many patients notice shortness of breath that can occur even at rest or with minimal activity. Tachypnea is also commonly seen on exam. The other symptoms listed are less typical: a productive cough might occur with infection or other lung processes, a chest rash points toward dermatologic or systemic conditions, and abdominal pain is not a typical feature of PE. While chest pain can occur if there’s pleural irritation, the symptom most often reported by patients with PE is dyspnea.