Thoracic Research and Practice
ORIGINAL INVESTIGATIONS

Evaluation of Clinical, Instrumental and Laboratory Findings in Patients With Acute Pulmonary Embolism Diagnosed by Spiral CT Angiography

1.

Department of Chest Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey

2.

Department of Chest Diseases, Atatürk University Faculty of Medicine, Erzurum, Turkey

3.

Department of Emergency Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey

4.

Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey

5.

Department of Radiology, Atatürk University Faculty of Medicine, Erzurum, Turkey

Thorac Res Pract 2005; 6: Turkish Respiratory Journal 95-101
Read: 479 Downloads: 304 Published: 12 October 2021

Objective: To investigate the correlations between spiral CT angi­ography and symptoms, signs, laboratory and instrumental findings in patients with suspected pulmonary embolism (PE).

Methods: Thirty-seven consecutive patients with suspicion of PE were included in the study. Electrocardiography, chest radiography, arterial blood gases analysis and D-dimer assay were performed in all patients. Five patients were excluded from the study due to low cli­nical probability and normal D-dimer levels. Spiral CT angiography and transthoracic echocardiography were applied to 32 patients with low clinical probability for PE and increasing D-dimer level (n=7), intermediate clinical probability for PE (n=5) and high pro­bability (n=20). The patients were classified as group 1, those with PE (n=21) and group 2, those without PE (n=ll).

Results: The two groups were similar in age and sex. Substernal pain (61.9%), dyspnea (100%) and syncope (28.6%) were signi­ficantly more frequent in group 1. Frequency of tachycardia (81%), tachypnea (95.2%), hemoptysis (47.6%) and circulatory collapse (28.6%) were also significantly higher in group 1. S1Q3T3 and sinus tachycardia were significant ECG findings and pleural effusion (81%), atelectasis (71.4%), pleural based opacity (71.4%) and prominent central pulmonary artery were also significant findings, in group 1. Mean values for pH, PaO2, PaCO2, O2sat % and alveolar-oxygen gradient in groups 1 and 2, in respective order, were: 7.44±0.04 versus 7.4O±O.OO7; 49.54+9.07 versus 63.34±16.05; 31.63±8.21 versus 37.32+9.74; 81.08±5.36 versus 88.58±8.61 and 60.92+14.96 versus 40.01 + 14.36. All echocardiographic abnormalities were of signi­ficantly higher frequency in group 1.

Conclusion: Spiral CT angiography can be used as a first line and safe diagnostic method in patients with suspected PE.

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