Signs and symptoms can vary and range from subtle to complete cardiovascular collapse.
- Awake patients can become restless, and complain of dyspnoea or chest pain.
- Cardiovascular signs:
- Variety of arrhythmias, from tachycardias to asystole.
- Jugular venous distension as a manifestation of pulmonary hypertension
- ‘Mill wheel’ murmur
- Hypotension and profound cardiogenic shock
- Neurological signs: may be very subtle or obvious and may include:
- Altered mental status
- Seizures,
- Focal weakness,
- Cranial nerve dysfunction,
- Hemiparesis/hemiplegia
- Coma.
- Delayed or improper neurological recovery can be seen in anaesthetised patients after surgery
- Some very subtle but diagnostic clinical signs may occasionally be seen, e.g. Cutis marmorata, a marble skin rash. Careful fundoscopy may demonstrate gas bubbles in the retinal vessels and examination of the tongue may show Liebermeister’s sign which is pallor of the tongue due to arteriolar obstruction with gas bubbles
