Muhammad Irfan, Shah Zeb, Kaleem Ullah Bacha.
Pulmonary embolism risk factors, presentation and management: a cross sectional study.
Pak Heart J Jan ;52(1):176-9.

Objective: To analyse the presenting symptoms, risk factors, management and outcome of patients admitted with pulmonary embolism. Methodology: Patients admitted to Cardiology department, Lady Reading Hospital, Peshawar as pulmonary embolism in the last 18 months, from 1st January 2018 to 10th June 2019, were enrolled utilizing convenient sampling.Patients were analyzed for presenting symptoms, risk factors, hemodynamic parameters,Well's score, ECG, Echo, CTPA parameters, treatments received and mortality. Frequency, mean and standard deviation were determined. Sensitivity and specificity was calculated for ECG signs, RV dilatation and pulmonary hypertension against CTPA. Results: Out of 5917 admissions 31 (0.5%) patients were diagnosed as pulmonary embolism. Mean age 46 + 16 years, male 45.2 %. The presenting symptoms were dyspnea 96.8%, chest pain 61.3% and dizziness 32.3%. Risk factors were immobilization 80.6%, hypertension 41.9% and diabetes 25.8%. D dimmers were high in 96.3%. Right ventricular dilatation was documented in 77.4% having sensitivity 87.5% and specificity 20%. Pulmonary hypertension was determined in 74.2% with sensitivity 81% and specificity 40%. CTPA was performed in 19 out of 31(61.3%) patients and of them 14/19 (73.6%) had evidence of pulmonary embolism. Anticoagulants were given in 90.3% while thrombolytic in 9.7%. Mortality was 5/5917 (0.1%) of the total admissions and 5/31 (16.1%) of the patients admitted as pulmonary embolism. The hospital mortality was zero in those having no pulmonary clot on CTPA. Conclusion: Dyspnea is the most common presenting symptom in pulmonary embolism. Immobilization is the most common risk factor for pulmonary embolism. The in hospital mortality of Pulmonary embolism is 16% in our study population.

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