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CLINICAL AND PARACLINICAL CHARACTERISTICS OF INTERMEDIATE – HIGH RISK PULMONARY EMBOLISM PATIENTS
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Abstract
Background: Intermediate – high risk pulmonary embolism accounts for a relatively high portion of all hospitalized patients with the diagnosis of pulmonary embolism. These patients have the potential for pulmonary embolism – related complications and may required scale up the treament strategy, and then should be closely monitored. There are limited domestic data in Vietnam describing this target group recently. Objective: To describe the clinical and paraclinical characteristics of hospitalized intermediate – high risk pulmonary embolism patients. Patients and methods: A descriptive cross – sectional, retrospective and prospective study, from 01/01/2022 to 30/05/2023, at the Department of Cardiology, Cho Ray Hospital. Results: 75 cases was enrolled with an average age of 62,28 ± 17,28 years old, female accounted for the majority (64%). Obesity accounted for 28% and was also the most common risk factor. Dyspnea (84%) and tachycardia (74,66%) were the main symptom and sign. The mean PESI score was 105,76 ± 32,84 points. Most patients had elevated troponin and NT-proBNP. Sinus tachycardia (68%) was the most common ECG abnormality. All patients had right ventricular failure with a mean TAPSE of 14,19 ± 2,73 mm. Pulmonary artery thrombus was mainly distributed in the main branch (64,67%), 85,33% of patients had bilateral thrombosis. Deep vein thrombosis was observed in 60% of cases. Nearly one third of the patients had deteriorated clinical conditions during in-hospital stay. Conclusion: Intermediate – high risk pulmonary embolism mainly occured in elderly, female patients. Obesity may be associated with disease severity. In most cases, there were various manifestations of right ventricular failure on the paraclinical features. A high percentage of patients developed decompensation during follow-up. A better understading of clinical and paraclinical characteristics may be useful in better risk stratification and appropriate management
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Keywords
pulmonary embolism, venous thromboembolism, right heart failure
References
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