Pulmonary thrombo-embolism may cause symptoms and signs that are easily confused with those due to cardiac disorders. This paper describes illustrative examples from 51 patients we have studied with pulmonary embolism who were initially thought to have a cardiac illness. Seventeen presented with right heart failure, 15 had chest pain with the distribution usually associated with myocardial ischaemia or infarction, 11 had pulmonary oedema and 6 had a cardiac arrhythmia. The possible mechanisms that lead to these various cardiac presentations of pulmonary emboli are discussed.
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