STUDY ON CLINICAL FEATURES AND IMAGE CHARACTERISTICS OF PATIENTS WITH ACUTE PULMONARY EMBOLISM AT CAN THO CENTRAL GENERAL HOSPITAL IN 2021-2023

Anh Khoa Huynh1,, Bùi Ngọc Thuấn1, Đoàn Dũng Tiến1, Thi Anh Thu Pham1
1 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Background: Acute pulmonary embolism is a common acute cardiovascular syndrome. Accurate and timely diagnosis to initiate treatment is very important, helping to reduce mortality and morbidity rates. Objectives: To decribe the clinical and imaging characteristics of patients with acute pulmonary embolism at Can Tho Central General Hospital in 2021-2023. Materials and methods: A prospective, descriptive cross-sectional study was conducted on 55 patients with acute pulmonary embolism at Can Tho Central General Hospital in 2021-2023. Results: The mean age was 65.3 ± 11.4, the male/female ratio was 1/1.6. The most common clinical symptom was dyspnea (81.8%), tachypnea (60%). All the cases where the D-dimer test was performed showed a D-dimer (+) result. Normal chest radiograph results accounted for 32.7%. On echocardiography, signs of right ventricular dilatation accounted for 36.4%. Deep vein thrombosis of the lower extremities and proximal deep vein thrombosis account for a high proportion (69.1% and 65.5%). Acute pulmonary embolism occurs more frequently on the right side than on the left side (92.7% vs 74.5%), in the lower lobe branches more often than in the upper and middle lobe branches (87.3% right, 67.3% left). Conclusions: Acute pulmonary embolism had diverse clinical symptoms. Computed tomography of the pulmonary artery was an imaging technique that plays an important role in the diagnosis. Acute pulmonary embolism occured more often on the right side than on the left, and more often in the inferior lobe branches than in the superior and middle lobe branches.

Article Details

References

1. Konstantinides S.V., Meyer G., Becattini C., Bueno H., et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). European Heart Journal. 2019. 41(4), 543-603. https://doi.org/10.1093/eurheartj/ehz405.
2. Pollack C.V., Schreiber D., Goldhaber S.Z., et al. Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry). J Am Coll Cardiol. 2011, 57(6), 700-706. https://doi.org/10.1016/j.jacc.2010.05.071.
3. Kim T.J., Lee K.H., Choe Y.H., Lee K.S. Emergency Chest Radiology. Springer. 2021. 161.
4. White C.S., Kuo D., Kelemen M., Jain V., et al. Chest pain evaluation in the emergency department: can MDCT provide a comprehensive evaluation? AJR Am J Roentgenol. 2005. 185(2), 533-540. https://doi.org/10.2214/ajr.185.2.01850533.
5. Beckman M.G., Hooper W.C., Critchley S.E., Ortel T.L., et al. Venous thromboembolism: a public health concern. Am J Prev Med. 2010. 38(4), 495-501. https://doi.org/10.1515/rjim-2017-0026.
6. Nguyễn Thị Tuyết Mai, Trần Thị Xuân Anh, Bùi Thế Dũng và cộng sự. Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị TTP do huyết khối tại Bệnh viện Đại học Y Dược thành phố Hồ Chí Minh. Y học thành phố Hồ Chí Minh. 2019. 23(2), 208-13.
7. Nguyễn Hoàng Hiệp. Nghiên cứu đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân thuyên tắc phổi cấp do huyết khối tại Bệnh viện Đa khoa Trung Ương Cần Thơ năm 2021-2022. Trường Đại học Y Dược Cần Thơ. 2022. 46-48.
8. Moore A.J.E., et al. Imaging of acute pulmonary embolism: an update. Cardiovascular diagnosis and therapy. 2018. 8(3), 225–243. https://doi.org/10.21037/cdt.2017.12.01.
9. Kilic H., et al. Normal Chest X-Ray in Patients with Pulmonary Embolism May Involve Increased Risk of Massive Pulmonary Embolism. European Journal of Medical and Health Sciences. 2022. 4(1), 1-4. http://dx.doi.org/10.24018/ejmed.2022.4.1.910.
10. Elliott C.G., et al. Chest radiographs in acute pulmonary embolism. Results from the International Cooperative Pulmonary Embolism Registry. Chest vol. 2000, 118(1), 33-8. doi:10.1378/chest.118.1.33.
11. Nguyễn Quang Đợi. Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và một số yếu tố nguy cơ tắc động mạch phổi cấp ở bệnh nhân đợt cấp bệnh phổi tắc nghẽn mạn tính. Trường Đại học Y Hà Nội. 2019. 89.
12. Qanadli S.D., El Hajjam M., Vieillard-Baron A., et al. New CT index to quantify arterial obstruction in pulmonary embolism: comparison with angiographic index and echocardiography. AJR. American journal of roentgenology. 2001. 176(6), 1415–1420. https://doi.org/10.2214/ajr.176.6.1761415.
13. Dương Thị Thu Hà, Võ Tấn Đức, Trần Thị Mai Thùy và cộng sự. Khảo sát tương quan giữa các chỉ số trên cắt lớp vi tính với triệu chứng lâm sàng và các chỉ số trên siêu âm tim trong đánh giá độ nặng của thuyên tắc động mạch phổi. Y học thành phố Hồ Chí Minh. 2021. 25(1), 1-8.
14. Attia N.M., Seifeldein G.S., Hasan A.A., Hasan A. Evaluation of acute pulmonary embolism by sixty-four slice multidetector CT angiography: Correlation between obstruction index, right ventricular dysfunction and clinical presentation. Egyptian J Rad and Nu Med. 2014. 46(1), 2532. https://doi.org/10.1016/j.ejrnm.2014.10.007.