When pulmonary emboli are found at autopsy, one question is how much the emboli may have contributed to the patient's death. To answer this question requires knowing the extent of circulatory obstruction and the presence of underlying cardiopulmonary disease.


Impact of pulmonary emboli:

(1) probably lethal

(2) possibly lethal

(3) contributory

(4) nonlethal


Probably lethal:

(1) large embolus in the main pulmonary artery (may extend into the right ventricle)

(2) large embolus at the bifurcation of the pulmonary artery (saddle embolus)

(3) large emboli in both left AND right main pulmonary arteries


Possibly lethal:

(1) large embolus in either the left OR right main pulmonary artery

(2) emboli in 2 or more lobar arteries on 1 side AND 1 or more lobar arteries on the contralateral side

(3) widespread emboli in the lobar, segmental and subsegmental arteries


Contributory: extensive pulmonary emboli not meeting the above criteria in a person with pre-existing cardiopulmonary disease and no other plausible explanation.


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