[The traps of pulmonary embolism].
The clinical diagnosis of pulmonary embolism (PE), even massive, remains difficult and perplexing. In our hospital, the percentage of exact clinical diagnoses has not significantly changed over recent years, with a false-negative rate of 78%, and a false-positive rate of 2%. In approximately 20% of cases, autopsy showed several emboli and pulmonary infarctions of various ages, indicating recurrent embolic episodes. The diseases most frequently associated were cardiac diseases (51%) and tumours (24%). Pneumonia considerably decreases the probability of an exact diagnosis of PE; hospitalisation in the Cardiology department or Intensive Care Unit increased the probability of this diagnosis. While the numerous diagnostic algorithms recently proposed have a limited value, the process integrating clinical and instrumental data in order to establish a prospective clinical probability, should facilitate identification of acute PE in live patients.
Morpurgo
M
M
Département de Cardiologie, Hôpital San Carlo Borromeo, Milan, Italie.
D000208:Acute Disease; D000465:Algorithms; D001344:Autopsy; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000473:pathology; D013923:Thromboembolism / Q000175:diagnosis / Q000473:pathology
Les pièges de l'embolie pulmonaire.