Heart disease in patients with pulmonary embolism.
OBJECTIVE
Several heart diseases are promoters of left-side cardiac thrombosis and could lead to arterial embolism. The same mechanism may be responsible for right-side cardiac thrombosis and therefore be a direct source of pulmonary embolism.


RESULTS
Yasuoka et al. showed a higher incidence of perfusion defects in lung scan in patients with spontaneous echocontrast in the right atrium than in those without it (40% and 7% respectively; P=0.006). We recently assessed the prevalence of heart diseases in 11.236 consecutive patients older than 60 years discharged from Venetian hospitals with a diagnosis of pulmonary embolism. We observed a higher prevalence of all-cause heart diseases (odds ratio 1.26; 95% confidence interval, 1.13-1.40) in patients with a diagnosis of pulmonary embolism alone (secondary or unprovoked) compared with those discharged with a diagnosis of pulmonary embolism associated with deep vein thrombosis, generating the hypothesis that some specific heart diseases in older patients could themselves be a possible source of pulmonary emboli.


CONCLUSIONS
Further prospective studies are required to confirm these findings, which have the potential to open new horizons for the interpretation and management of venous thromboembolic disease.
Department of Cardiothoracic and Vascular Sciences, 2nd Chair of Internal Medicine, Thromboembolism Unit, University of Padua, Padua, Italy. r.pesavento@libero.it
Raffaele
R
Pesavento
Chiara
C
Piovella
Paolo
P
Prandoni
D000368:Aged; D000369:Aged, 80 and over; D006331:Heart Diseases / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007558:Italy; D008875:Middle Aged; D015995:Prevalence; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D020246:Venous Thrombosis / Q000150:complications / Q000503:physiopathology