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[Diagnostic problems in acute pulmonary embolism].

P Berchtold, M Genoni, B Frauchiger

    Schweizerische Medizinische Wochenschrift
    |December 1, 1984
    PubMed
    Summary
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    Diagnosing acute pulmonary embolism relies on identifying key symptoms like breathlessness and chest pain. Arterial hypoxemia and isotope scanning are most effective, unlike radiological and electrocardiographic findings.

    Area of Science:

    • Pulmonary Medicine
    • Diagnostic Imaging
    • Cardiology

    Background:

    • Acute pulmonary embolism (PE) is a significant cause of morbidity and mortality.
    • Accurate and timely diagnosis is crucial for effective treatment.
    • Previous studies, like the urokinase pulmonary embolism trial, have informed diagnostic criteria.

    Purpose of the Study:

    • To analyze historical, clinical, and laboratory findings in acute pulmonary embolism cases.
    • To compare diagnostic value of various tests.
    • To identify challenges in differential diagnosis.

    Main Methods:

    • Retrospective analysis of 729 acute pulmonary embolism cases (1978-1982).
    • Evaluation of patient history and clinical signs.
    • Assessment of laboratory findings, including radiological, electrocardiographic, arterial blood gas analysis, and isotope scanning.

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  • Comparison with urokinase pulmonary embolism trial data.

    • Main Results:

    • Dominant clinical features included breathlessness, chest pain, tachypnea, tachycardia, and cyanosis.
    • Radiological and electrocardiographic findings for pulmonary hypertension had limited diagnostic value.
    • Arterial hypoxemia and isotope scanning demonstrated the highest diagnostic reliability.
    • Acute myocardial infarction was the most common differential diagnosis challenge.

    Conclusions:

    • Clinical presentation offers important clues for acute pulmonary embolism diagnosis.
    • Arterial hypoxemia and isotope scanning are superior diagnostic tools compared to traditional radiological and electrocardiographic methods for pulmonary hypertension.
    • Differentiating acute pulmonary embolism from acute myocardial infarction remains a diagnostic challenge.