CLINICAL AND PARACLINICAL ASPECTS IN PULMONARY THROMBOEMBOLISM
Objectives: Pulmonary thromboembolism is a disease whose diagnosis can be difficult. The objective of this study was to assess the clinical and paraclinical characteristics of patients with pulmonary thromboembolism confirmed by pulmonary angiotomography.
Material and methods: The study included 36 patients with pulmonary thromboembolism confirmed by pulmonary angioCT admitted during 2011 in our clinic. For each patient the Wells probability score was calculated, other clinical (systolic blood pressure, heart rate, O2 saturation at admission) and paraclinical (D dimer, ECG, RV size and systolic pulmonary artery pressure at echocardiography) parameters were analysed. Also, the presence of venous thrombosis at venous ultrasound was noted.
Results: Sex distribution was even (19 men -52% and 17 women – 48%), mean age being 65 ± 13 years. Mean Wells score was 1,6 ± 1, 22 patients (61%) having a score greater than 1. Mean heart rate was 103 ± 25 b/min, 19 patients (52%) having a heart rate > 100 b/min. ECG changes (RBBB, RVH, right axis deviation, s1q3) were present in 13 patients (31%), and deep vein thrombosis was noted on 14 patients (39%). At echocardiography mean RV size was 30± 6 mm and mean pulmonary artery systolic pressure was 45 ± 18 mmHg. A value of > 5 for D dimer was present in 14 patients (39%).
Conclusions: An important percentage of patients with pulmonary thromboembolism do not have an increased Wells score, ECG, laboratory or echocardiographic changes (with the exception of increase in PsAP), meaning that its confirmation by angioCT is mandatory.