[Diagnostic aspects and results of drug therapy in pulmonary thromboembolism]

Out of a group of 28 patients examined for suspected pulmonary thromboembolism (PTE), the diagnosis was confirmed by angiopneumography in 18 cases. In these patients the symptoms and clinical, electrocardiographical, radiological and scintiphotographical findings corresponded with those reported in the literature. 9 patients were treated with Urokinase (UK) at the dosages recommended by the Food and Drug Administration (FDA), followed by full-dose heparin, and 9 were treated with heparin alone. All patients survived and were discharged undergoing warfarin treatment. Follow-up checks were made after 1 and 6 months. Most of the patients treated with UK showed signs of swift improvement (within 24 hours) in clinical and instrumental terms with no significant haemorrhagic complications. An improvement was also observed in patient treated with heparin alone after the first week of treatment. To conclude: a) clinical diagnosis of PTE is neither sensitive nor specific; b) standard blood tests, electrocardiogram, chest x-ray and lung perfusion scintiphotography display different degrees of sensitivity compared with angiopneumography but all have a poor specificity; c) thrombolytic treatment is safe and effective in selected cases; d) long-term clinical results do not depend on treatment given during the acute stage of the disease.