• The patient may have tachypnea (increased respiratory rate) and tachycardia (increased heart rate).

• The patient may appear diaphoretic (sweaty).

• The patient's neck veins may be distended reflecting increased jugular venous pressure.

• The examiner may hear diminished breath sounds, crackles, wheezes, or pleural friction rub, right ventricular S3, or parasternal lift during auscultation of the lungs.

• In massive PE, the patient may appear cyanotic and hypotensive. In such cases, oxygen saturation by pulse oximetry or arterial blood gas will likely indicate that the patient is hypoxic.

• In the worst cases, the patient may go into circulatory shock and die within minutes.

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