Pre-existing pulmonary thromboembolic disease in passengers with the "economy class syndrome".
BACKGROUND
Pulmonary emboli, which have occurred in association with air travel, in the past have been thought to have arisen from deep venous thromboses (DVT) which formed during the flight.


OBJECTIVE
This study was performed to test the idea that not all pulmonary emboli which occur following air travel are the result of inflight DVT formation.


METHODS
Fourteen cases of fatal "economy class syndrome" were examined histologically to determine the age of the fatal thromboemboli.


RESULTS
In 5 of the cases, evidence of pre-existing pulmonary thromboembolic disease was present and in 4 of these cases the fatal thromboemboli observed in the lung tissue pre-dated the flight. Fresh perimortem thrombus without evidence of organization or hemosiderin deposition was observed in 9 cases.


CONCLUSIONS
The commonly held pathological mechanism that the conditions of the flight lead to DVT formation and subsequent pulmonary embolism are not applicable in all cases of "economy class syndrome" and thus other pathophysiological mechanisms must be entertained.
Cheung
B
B
University of New South Wales, Australia.
Duflou
J
J
D000337:Aerospace Medicine; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014195:Travel; D020246:Venous Thrombosis / Q000150:complications* / Q000473:pathology