1、肺栓塞冠状动脉灌注右心室氧需右心室壁张力右心室排血量右心室氧供左心室排血量肺动脉压力右心室后负荷解剖阻塞 神经、体液作用、低氧引起右心室扩张/功能不全 右心室缺血室间隔移向左心室低血压体循环灌注左心室前负荷Peer Review Status:Externally Peer Reviewed by the AMA0 010102020303040405050606070708080发生率%发生率%呼吸困难呼吸困难胸痛胸痛咳嗽咳嗽下肢水肿下肢水肿下肢疼痛下肢疼痛咳血咳血心悸心悸喘息喘息类心绞痛类心绞痛 疑诊疑诊 疑诊疑诊 疑诊疑诊图12000年8月27日（急诊）ECG大致正常2000年8月29日
2、（门诊）ECG示RBBB SQTV1V2T波倒置V3V4T波双向 疑诊疑诊0 01010202030304040505060607070发生率%发生率%正常正常肺不张或实变肺不张或实变胸腔积液胸腔积液胸膜肥厚胸膜肥厚纵隔上抬纵隔上抬肺动脉搏增宽肺动脉搏增宽Westermark征Westermark征心脏增大心脏增大肺水肿肺水肿Peer Review Status:Externally Peer Reviewed by the AMA 疑诊疑诊 疑诊疑诊 疑诊疑诊 确诊确诊LA7+8 确诊确诊 确诊确诊 确诊确诊正常肺动脉 确诊确诊This selective study was done because of a perfusion defect in the left lower lobe on a ventilation perfusion scan.The first angiographic study was inconclusive.Therefore,a subselective study was done that demonstrated the clot with certainty.治疗治疗 治疗治疗 治疗治疗 治疗治疗 治疗治疗 治疗治疗 治疗治疗 治疗治疗 治疗治疗治疗治疗治疗治疗 治疗治疗对高危人群：
