Clinical and echocardiographic findings of patients with suspected acute pulmonary thromboembolism who underwent computed tomography pulmonary angiography

Abstract

Background: The aim of the study is to determine the correlation between clinical and echocardiographic fi ndings and risk factors of patients with suspected acute pulmonary thromboembolism (PTE) who underwent computed tomography pulmonary angiography (CTPA). Materials and Methods: In this cross-sectional study, 310 hospitalized patients aged >18 years with high clinical suspicion of PTE referred to imaging center of our hospital from diff erent wards for CTPA were enrolled. The frequency of diff erent clinical presentations, risk factors, items of Wells’ criteria, and echocardiographic fi ndings was compared in patients with and without PTE, which have been diagnosed according to the CTPA results. Results: PTE was diagnosed in 53 (17.1%) of patients with suspected PTE. From clinical manifestations, tachypnea, pleuritic chest pain, and edema of lower extremities were signifi cantly more frequent among patients with PTE (P < 0.05). Major surgery was the risk factor which was signifi cantly more prevalent among patients with PTE (P < 0.05). Frequency of all criteria of Wells’ criteria, except hemoptysis, was signifi cantly higher in patients with
PTE (P < 0.05). The frequency of all studied echocardiographic variables was signifi cantly higher in patients with PTE (P < 0.05).Conclusion: It is suggested that we could use the results of this study for utilizing the diagnostic process of PTE in patients with highly clinical suspicion of PTE and providing more validated decision. Using the results of this study, we could identify high-risk patients and made appropriate risk assessment for better management of patients with suspected PTE as well as reduce the rate of unnecessary CTPA and its related adverse consequences.

Key words: Computed tomography pulmonary angiography, echocardiography, pulmonary thromboembolism, risk factor,
Wells’ criteria