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Part I. A Clinicopathological Investigation of 100 Cases of Massive Embolism of the Pulmonary Artery; Diagnosis by Physical Signs and Differentiation from Acute Myocardial Infarction

L. WHITTINGTON GORHAM, M.D.

Arch Intern Med. 1961;108(1):8-22.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

No condition is less often diagnosed correctly than massive pulmonary embolism. The purpose of this communication is to show that (1) a high percentage of diagnotic errors is made in it, (2) that there are definite reasons for these mistakes, and (3) that there appears to be a possibility of increasing general diagnostic accuracy by systematic examination of the patient for certain physical signs.

Until Herrick's¹ classical description of acute myocardial infarction in 1912, sudden deaths were frequently and often erroneously attributed to massive pulmonary embolism. In recent years the pendulum has swung in the other direction. Sudden deaths occurring at the present time are prone to be ascribed to acute myocardial infarction. It is true that in any large series of sudden deaths, as Hamman² has pointed out, 40% will be found to have myocardial infarcts, and only 5% pulmonary emboli. The odds, therefore, are 8 to . . . [Full Text PDF of this Article]

Author Affiliations
NEW YORK

From the Department of Pathology, New York Hospital-Cornell Medical Center.; Research Associate in the Department of Pathology; Research Consultant, Goldwater Memorial Hospital, First Research Service of the College of Physicians and Surgeons, Columbia University; Professor of Medicine (Emeritus), Albany Medical College of Union University; Director (Emeritus) of the Public Health Research Institute of the City of New York, Inc.

Footnotes
Submitted for publication Aug. 19, 1960.

Part I was presented in summary form at the 68th Annual Meeting of the American Clinical and Climatological Association, November, 1955, Vol. LXVII of the Transactions; also at the Second Inter-European Congress of Cardiology at Stockholm, September, 1956.

Editor's Note.—Only Part I of this excellent monograph appears in the current issue of the Archives. Part II: The Mechanism of Death; Based on a Clinicopathological Investigation of 100 Cases of Massive and 285 Cases of Minor Embolism of the Pulmonary Artery, and Part III: The Mechanism of Pain; Based on a Clinicopathological Investigation of 100 Cases of Minor and 100 Cases of Massive Embolism of the Pulmonary Artery, will appear next month. The tables are quite extensive, so only selected cases from the longer ones will appear in these pages. Full tables will be included in the author's reprints.

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