title: Frequency of pulmonary embolism in patients admitted with chest pain and suspicion of acute myocardial infarction but in whom this diagnosis is ruled out.
abstract: The purpose of this study was to determine the frequency of pulmonary embolism in patients admitted with acute chest pain but without myocardial infarction (non-AMI patients). We examined 175 consecutive non-AMI patients without unstable angina pectoris within the first 48 h of admission. The patients were first examined by perfusion pulmonary scintigraphy. If the scintigraphy was abnormal, it was combined with a 81mKr ventilation scintigraphy. Perfusion scintigraphy was abnormal in 21 patients, and the subsequent combined perfusion/ventilation scintigraphy was used to identify 5 patients (2.5%) who had a high probability for pulmonary embolism, which was not clinically suspected at the time of admission. Three of these 5 patients had a decreased arterial oxygen tension upon admission, and 3 had abnormalities in their electrocardiogram. Pulmonary embolism only occurred in 2.5% of the non-AMI patients. The prognosis of untreated patients, however, it markedly worse as compared with treated patients. We, therefore, suggest that pulmonary scintigraphy be performed in non-AMI patients who have uncharacteristic electrocardiographic changes and/or a low arterial partial oxygen tension when no other abnormality has been found within 24 h of admission.
authors.affiliation: Medical Department B, Hillerød Sygehus, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Fruergaard
authors.forename: J
authors.initials: J
authors.lastname: Launbjerg
authors.forename: B
authors.initials: B
authors.lastname: Hesse
mesh_terms: D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007727:Krypton Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011379:Prognosis; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D011877:Radionuclide Imaging; D012189:Retrospective Studies
chemical_list: D007727:Krypton Radioisotopes