Pulmonary embolism – 17 Cases analysis
Keywords:
Pulmonary embolism, casuistic, thoracic spiral computed tomographyAbstract
Pulmonary embolism (PE) is an important cause of cardiovascular morbidity and mortality. A retrospective three years study of PE,
confirmed by perfusion lung scanning and/or spiral computed tomography, in the Internal
Medicine I Service of Santa Maria Hospital is presented. Comparative analysis of the international literature in this field is referred. Data from 17 patients (9 females, 8 males; mean age:
62.4±16.8 years) with previous surgery and/or immobilization was reviewed. The majority of
the patients presented non-massive PE (52.9%) associated with dyspnea (58.8%) and right
ventricular dysfunction (52.9%). Laboratory findings: hypoxaemia (41.2%), elevated lactic acid dehydrogenase (52.9%), d-dimers (35.5%) and fibrinogen (35.5%). Atrial tachycardia was observed on the electrocardiogram in 70.6% of
patients. Transthoracic echocardiography revealed right ventricular dysfunction/dilatation
in 9.4%. Imagiologic approach often shows a
chest film with an enlarged right descending pulmonary artery (29.4%), perfusion lung scanning
indicating a high probability of disease (47.1%) and spiral computed tomography with PE in the proximal pulmonary vascular tree (35.3%).
All our patients were prescribed anticoagulant therapy. Two patients (11.8%) died.
Downloads
References
Silverstein MD et al. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25 year population based study. Arch Intern Med 1998; 158: 585-593.
Giuntini C et al. Epidemiology. Chest 1995; 107 (Supp I): 3S-9S.
Nápoles Sarmento JL. Embolia pulmonar e outras doenças cardiovasculares. Em Pneumologia na prática clínica. 2ª Ed. Antunes e Amilcar
eds. 1992; vol II; XXII: 789-813.
Anderson FA et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism: the Worcester DVT Study Arch Intern Med 1991; 151: 933-938.
Task Force on Pulmonary Embolism; European Heart Society of Cardiology. Guidelines on diagnosis and management of acute pulmonary
embolism. Eur Heart J 2000; 21: 1301-1336.
Goldhaber SZ. Medical progress: pulmonary embolism. N Engl J Med 1998; 339: 93-104.
Goldhaber SZ. Pulmonary thromboembolism in Fauci AS et al. Harrison´s Principles of Internal Medicine. 14 th ed. McGraw-Hill
Companies eds 1998; 261: 1469-1472.
Morpurgo M et al. Factors influencing the clinical diagnosis of pulmonary embolism: analysis of 229 postmortem cases. Int J Cardiol 1998;
(Suppl I): S79-S82.
Dionisio P. Tromboembolismo pulmonar com confirmação angiográfica: aspectos clínicos e prognósticos. Rev Port Cardiol 1999; 18 (6):
-585.
Ferrari E et al. The ECG in pulmonary embolism: predictive value of negative T waves in precordial leads – 80 case reports. Chest 1997;
: 537-543.
Abreu TT, Correia J. Tromboembolismo pulmonar: um caso típico e a sua abordagem. Rev Port Cardiol 2000; 19 (2): 251-254.
Simons GR et al. Quantitative plasma D-dímer levels among patients undergoing pulmonary angiography for suspected pulmonary embolism. JAMA 1993; 270: 2819-2822.
Zimhony O. Diagnosis of pulmonary embolism. N Engl J Med 1998; 339: 1084-1085.
Goldhaber SZ. Treatment of acute pulmonary embolism. In: Goldhaber ed. Cardiopulmonary diseases and cardiac tumors. Vol. 3 of Atlas of
heart diseases. Philadelphia: Current Medicine 1995
Galrinho A e col. Importância da ecocardiografia transesofágica multiplanar no diagnóstico de tromboembolismo pulmonar. Rev Port
Cardiol 1999; 18 (1): 45-51.
Tapson VF. Pulmonary embolism – new diagnostic approaches. N Engl J Med 1997; 336: 1449-1451.
Garg K et al. Pulmonary embolism: diagnosis with spiral CT and ventilation – perfusion scanning – correlation with pulmonary angiographic results or clinical outcome. Int J Cardiol 1998; 208: 201-208.
Remy Jardin M et al. Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with single-breath-hold tecnique - comparison with pulmonary angiography. Radiology 1992; 185: 381-387.
Kasper W et al. Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart 1997; 77: 346-349
Additional Files
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
