Document Detail


Gender, age and clinical signs in patients suspected of pulmonary embolism.
MedLine Citation:
PMID:  8177965     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied 196 patients with suspicion of pulmonary embolism (PE) to evaluate the role of clinical pattern, with special reference to gender and age, in raising the suspicion. Results are that clinical and instrumental patterns, although not specific for PE, may show highly frequent symptoms and signs such as dyspnea (52%), chest pain (60%), enlargement of descending pulmonary artery (49%), diaphragmatic elevation (41%), enlargement of azygos vein (46%) and hypoxia (mean value 68 +/- 13 mm Hg) that allow to suspect PE in most patients and, therefore, to recruit more patients for diagnosis. Moreover, this study shows that gender and age may only partially influence the possibility of raising the suspicion of PE. Indeed, only hemoptysis is significantly (p < 0.02) more frequent in males; only pleuritic chest pain is significantly (p < 0.02) more frequent in youngs; few instrumental findings, such as 'sausage-like' descending pulmonary artery (p < 0.001), enlargement of cardiac shadow (p < 0.01), and hypoxia (p > 0.03) are significantly more frequent in elderly patients. Finally, a characteristic clinical and instrumental pattern of PE may allow to select a subset of patients at higher risk; in fact, previous PE, prolonged immobilization (p < 0.01) and thrombophlebitis (p < 0.001), sudden dyspnea and cough (p < 0.05), 'sausage-like' descending pulmonary artery (p < 0.001), diaphragm elevation (p < 0.02), enlargement of heart shadow, pulmonary infarction and Westermark sign (p < 0.001), S-T segment depression (p < 0.001), and hypoxia (p < 0.001) are findings significantly more frequent in patients with confirmed PE.
Authors:
V Donnamaria; A Palla; C Giuntini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Respiration; international review of thoracic diseases     Volume:  61     ISSN:  0025-7931     ISO Abbreviation:  Respiration     Publication Date:  1994  
Date Detail:
Created Date:  1994-06-09     Completed Date:  1994-06-09     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0137356     Medline TA:  Respiration     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM; S    
Affiliation:
University of Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Blood Gas Analysis
Chest Pain / etiology
Diagnostic Imaging
Electrocardiography
Female
Hemoptysis / etiology
Humans
Immobilization / adverse effects
Male
Middle Aged
Pulmonary Embolism / complications,  diagnosis*,  etiology
Risk Factors
Sex Factors
Thrombophlebitis / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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