Abstract
Pulmonary infarction occurs in nearly one-third of the patients with acute pulmonary
embolism. Infarcts are still often mistaken for pneumonia or lung cancer because of
the deeply rooted belief that they ought to be triangular in shape. In reality, the
apical portion of an embolized region is spared from infarction thanks to sufficient
collateral blood flow. Infarcts are always arranged peripherally along the surface
of the visceral pleura (costal, diaphragmatic, mediastinal, or interlobar). Their
free margin is sharp and convex toward the hilum, casting a semicircular or cushion-like
density on chest radiography or computed tomography (CT). Focal areas of hyperlucency
within the infarction are often seen on CT. Clinical presentation is nonspecific.
Pleuritic chest pain, either isolated or in combination with abrupt dyspnea, is the
most frequent presenting symptom, whereas hemoptysis is much rarer. Recent data indicate
that younger age, increasing body height, and active cigarette smoking are independent
predictors of infarction in the setting of acute pulmonary embolism. Correct recognition
of pulmonary infarction is fundamental because pleural-based consolidations suggestive
of infarction may be the first manifestation of pulmonary embolism.
Keywords
pulmonary infarction - morphology - risk factors - diagnosis
