A pleural effusion is sometimes present that is exudative, detectable by decreased percussion note, audible breath sounds, and vocal resonance. Strain on the right ventricle may be detected as a left parasternal heave, a loud pulmonary component of the second heart sound, and/or raised jugular venous pressure. A low-grade fever may be present, particularly if there is associated pulmonary hemorrhage or infarction.As smaller pulmonary emboli tend to lodge in more peripheral areas without collateral circulation, they are more likely to cause lung infarction and small effusions (both of which are painful), but not hypoxia, dyspnea, or hemodynamic instability such as tachycardia. Larger PEs, which tend to lodge centrally, typically cause dyspnea, hypoxia, low blood pressure, fast heart rate and fainting, but are often painless because there is no lung infarction due to collateral circulation. The classic presentation for PE with pleuritic pain, dyspnea, and tachycardia is likely caused by a large fragmented embolism causing both large and small PEs. Thus, small PEs are often missed because they cause pleuritic pain alone without any other findings and large PEs are often missed because they are painless and mimic other conditions often causing ECG changes and small rises in troponin and brain natriuretic peptide levels.PEs are sometimes described as massive, submassive, and nonmassive depending on the clinical signs and symptoms. Although the exact definitions of these are unclear, an accepted definition of massive PE is one in which there is hemodynamic instability.
In ancient China, it was also used as a powerful tool to remove negative energies and drive away the hazards of daily life. Synthetic amethyst
Synthetic (laboratory-grown) amethyst is produced by a synthesis method called hydrothermal growth, which grows the crystals inside a high-pressure autoclave. Synthetic amethyst is made to imitate the best quality amethyst. Its chemical and physical properties are the same as that of natural amethyst and it can not be differentiated with absolute certainty without advanced gemmological testing (which is often cost-prohibitive). One test based on "Brazil law twinning" (a form of quartz twinning where right and left hand quartz structures are combined in a single crystal) can be used to identify most synthetic amethyst rather easily. Synthesizing twinned amethyst is possible, but this type is not available in large quantities in the market.Treated amethyst is produced by gamma ray, X-ray, or electron-beam irradiation of clear quartz (rock crystal), which has been first doped with ferric impurities. Exposure to heat partially cancels the irradiation effects and amethyst generally becomes yellow or even green. Much of the citrine, cairngorm, or yellow quartz of jewelry is said to be merely "burnt amethyst". Cultural history
Ancient Greece
The Greek word "amethystos" may be translated as "not drunken", from Greek a-, "not" + methustos, "intoxicated". Amethyst was considered to be a strong antidote against drunkenness, which is why wine goblets were often carved from it.