Pulmonary embolism: epidemiological data and diagnosis in Kinshasa hospitals

Pulmonary embolism (PE) is common but difficult to diagnose.

To describe the epidemiological, clinical and paraclinical characteristics of PE in Kinshasa hospitals.

This was a retrospective study in 158 cases with suspected PE.

The prevalence of PE was 37% among cases with suspicion of the disease. Male sex was predominant (55%). The mean age was 55 ± 15 years. The main risk factors were obesity (53%), immobilisation (43%) and surgery (14%). The main symptoms were dyspnoea (98%), cough (59%), chest pain (43%) and unilateral limb pain (36%). Tachypnoea (88%), tachycardia (53%) and signs of deep-vein thrombosis (36%) were the main clinical presentations. Lung examination was normal in 55% of the patients. PE prevalence in the 'PE likely' category based on the Wells score was 53%. Levels of D-dimers were elevated in all patients. Sinus tachycardia (72%), S1Q3T3 pattern (30%) and T-wave inversion in V1-V4 (34%) were the main electrocardiographic abnormalities. Chest X-ray was normal in 30% of patients. Right ventricular pressure overload was detected in 58% of patients who had access to echocardiography. Computed tomography pulmonary angiography was performed in 65% of patients. All patients were treated with anticoagulants; no cases received thrombolytics. Patients who died (7%) were all in class III-V according to the Pulmonary Embolism Severity Index prognostic score.

PE is common in Kinshasa, with characteristics similar to those reported in the literature.