Advanced Medical Life Support (AMLS)

Which clinical findings are most commonly associated with a pulmonary embolus?

1. Clear breath sounds with tachypnea

2. Rhonchi auscultated bilaterally with hypercarbia

3. Crackles heard in the bases with bradycardia

4. Fever, tachycardia, and tachypnea with increased work of breathing

The correct answer is: Clear breath sounds with tachypnea

The clinical findings most commonly associated with a pulmonary embolism are often characterized by a combination of respiratory and cardiovascular symptoms resulting from reduced blood flow in the lungs. Tachypnea, or increased respiratory rate, is a direct response to the decreased oxygenation of the blood caused by the embolism, as the body attempts to compensate for the impaired gas exchange. Clear breath sounds may still be present initially, especially in cases where the embolism does not significantly affect the lung tissue or cause an inflammatory response. In the case of pulmonary embolism, the absence of adventitious lung sounds like wheezing or crackles, along with the presence of tachypnea, indicates a readily identifiable clinical picture. The other findings such as hypercarbia and bradycardia usually signify different underlying respiratory or cardiac conditions, while fever is less commonly attributed to pulmonary embolism unless there is a concomitant infectious process or inflammatory response. Overall, the pattern of symptoms in the presence of tachypnea aligns well with an acute pulmonary embolism scenario.