myocardial infarction - in the early stages may not be ECG changes associated with MI. Changes associated with PE eg T-wave depression in V1-3, right bundle branch block are not constant findings. If there is excessive dyspnoea without pulmonary oedema then suspect a pulmonary embolism
acute internal haemorrhage - neck veins are engorged in pulmonary embolism
acute pancreatitis or bacteraemic shock have slower onsets than pulmonary embolism, and have low CVPs
cardiac tamponade - echocardiography can provide evidence of pericardial fluid
dissecting aortic aneurysm - chest radiography may show a widened aorta
pneumothorax and massive collapse of the lung - chest radiography will show characteristic changes.
generally pulmonary arteriography will normally demonstrate the obstructed zone
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