[Recurrent peripheral thromboembolism of the pulmonary artery in patients in a lung clinic]

It is reported on 87 patients suffering from recurrent peripheral thromboembolism of the pulmonary artery. In 62 cases there was a clinical diagnosis. Twenty five times thromboembolism was only recognized at autopsy. In particular at the higher ages the disease was frequently misdiagnosed. Bone fractures, longer lasting immobilisation, already existing heart insufficiency, chronic lung diseases and tumor-diseases favoured pathogenesis. The interval between the early symptoms and hospital admission lasted in 58 patients more than one month. Radiographic findings most frequently revealed expanded infiltrative lung-processes and pleural effusions. So-called "embolism-specific" findings we only found in 6 patients. Electrocardiographically only 23 patients showed signs of a right ventricular stress. Therefore the diagnosis should be based especially on anamnestic data and the synopsis of all clinical findings. Major support gave the lung perfusion scintigraphy (99mTc) with demonstration of a bilateral, multifocal loss of perfusion also in areas with no findings by X-raying.