Pulmonary embolism in Ibadan, Nigeria: five years autopsy report

The autopsy findings and clinical features in 60 patients with fatal pulmonary embolism (PE) in University College Hospital, Ibadan, between 1985 and 1989 are analysed in the current study. Pulmonary embolism occurred in 3,8 pc of all autopsied patients during this period. There was a male to female ratio 1,4 to one and average age was 47 years. Malignant neoplasms, infections and cardiac failure were the leading predisposing factors to PE identified. The ante-mortem clinical features consisted largely of non-specific respiratory symptoms of dyspnoea, cough, chest pain and haemoptysis. Of these patients, 15,6 pc were diagnosed ante-mortem as having PE. Pulmonary infarction occurred in 13,3 pc of the cases and was commoner in females and in patients with underlying cardiac diseases. This study emphasises the need for a high clinical index of suspicion to improve the antemortem diagnosis of this potentially fatal condition and to advocate a greater use of prophylactic anti-coagulant therapy in high risk patients.