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Prospective Study of Pulmonary Embolism Presenting as Syncope
Calin Pop1,2, Raluca Ianos1, Claudia Matei1
1Department of Cardiology, Emergency County Hospital Baia Mare, Baia Mare, Romania.
American Journal of Therapeutics
|May 15, 2019
Summary
Pulmonary embolism (PE) occurs in 2.52% of emergency department syncope cases and 11.47% of hospitalized syncope cases. Consider PE in unexplained syncope, especially with large thrombi causing proximal obstruction.
Area of Science:
- Emergency Medicine
- Cardiology
- Pulmonology
Background:
- Syncope is a common emergency department complaint.
- Pulmonary embolism (PE) is a potential cause of syncope, particularly when chest pain is absent.
Purpose of the Study:
- To determine the prevalence of PE in patients presenting with syncope to the ED.
- To assess PE prevalence in patients hospitalized for syncope at a tertiary care hospital.
Main Methods:
- Prospective observational study from January 2012 to December 2017.
- PE diagnosis confirmed via CT pulmonary angiography after risk stratification (Wells score, D-dimer).
- Defined syncope and PE using established professional guidelines.
Main Results:
- 17,082 patients presented with syncope to the ED.
- PE prevalence was 2.52% (45/1782) in ED syncope patients and 11.47% (45/392) in hospitalized syncope patients.
- Emboli were bilateral in 53.33% and proximal (main or lobar arteries) in 44.44% of PE cases.
Conclusions:
- Unexplained syncope warrants consideration of PE as a differential diagnosis.
- The prevalence of PE is higher in hospitalized syncope patients.
- Large thrombi causing proximal or bilateral pulmonary artery obstruction are associated with syncope.
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