Acute Cardiac Disorder or Pneumonia and Concomitant Presence of Pulmonary EmbolismReport as inadecuate




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Purpose

To determine the frequency of apparent acute pulmonary embolism PE and of concomitant disease in computed tomography pulmonary angiography CTPA; to compare the frequency of PE in patients with pneumonia or acute cardiac disorder acute coronary syndrome, tachyarrhythmia, acute left ventricular heart failure or cardiogenic shock, with the frequency of PE in patients with none of these alternative chest pathologies comparison group.

Methods

Retrospective analysis of all patients who received a CTPA at the emergency department ED within a period of four years and 5 months.

Results

Of 1275 patients with CTPA, 28 2.2% had PE and concomitant radiologic evidence of another chest disease; 3 more 0.2% had PE and an acute cardiac disorder without radiological evidence of heart failure. PE was found in 11 of 113 patients 10% with pneumonia, in 5 of 154 patients 3.3% with an acute cardiac disorder and in 186 of 1008 patients 18% in the comparison group. After adjustment for risk factors for thromboembolism and for other relevant patient’s characteristics, the proportion of CTPAs with evidence of PE in patients with an acute cardiac disorder or pneumonia was significantly lower than in the comparison group OR 0.13, 95% CI 0.05–0.33, p<0.001 for patients with an acute cardiac disorder, and OR 0.45, 95% CI 0.23–0.89, p = 0.021 for patients with pneumonia.

Conclusion

The frequency of PE and a concomitant disease that can mimic PE was low. The presence of an acute cardiac disorder or pneumonia was associated with decreased odds of PE.



Author: Martin Rohacek , Zsolt Szucs-Farkas, Carmen A. Pfortmüller, Heinz Zimmermann, Aristomenis Exadaktylos

Source: http://plos.srce.hr/



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