[Pulmonary thromboembolism: clinical characteristics and diagnostic and therapeutic approaches].
In the present study the variability and diagnostic meaning of clinical features and common laboratory investigations were evaluated in a series of 220 patients with pulmonary thromboembolism (PTE) diagnosed by clinical means. The patients were classified into the two following groups: group I consisted of 102 critical patients admitted to an intensive care unit; group II consisted of 118 less-severely ill patients admitted to an ordinary hospital ward. Although clinical and laboratory features were nonspecific, the association of thrombotic risk factors in 88% of the patients permitted us to suspect the diagnosis of PTE within the initial three days in 71%. Chest radiogram was normal in 48%, ECG was normal in 32%, and contrast phlebography did not demonstrate phlebothrombosis in 16.4% of cases. The presumptive diagnosis was earlier (4 +/- 2 days) in group I than in group II patients (8 +/- 5 days) (p less than 0.01), and there was a significantly higher frequency of thoracic symptoms, hypoxemia, hypocapnia and radiologic and electrocardiographic abnormalities in group I patients. Chest radiogram and ECG were normal in only a small minority of these patients (9 and 7%, respectively). Overall mortality rate was 9.4% (20 patients, 14 from group I and 6 from group II). In 10 patients, all from group I, death took place within the first 72 hours after the diagnosis.
Arnalich
F
F
Monereo
A
A
López
J
J
Arribas
J R
JR
Jiménez
M
M
Lahoz
C
C
Peña
J M
JM
Barbado
F J
FJ
Vázquez
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D011859:Radiography; D012307:Risk Factors
Tromboembolismo pulmonar: características clínicas y actitudes diagnóstica y terapéutica.