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Chronic pulmonary thromboembolism.

M Tartulier, J Boutarin, B Ritz

    Giornale Italiano Di Cardiologia
    |January 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

    Recurrent pulmonary embolism can cause pulmonary arterial hypertension and right heart failure. Early diagnosis is challenging due to subtle symptoms and requires advanced imaging like pulmonary angiography.

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    Area of Science:

    • Cardiology
    • Pulmonology
    • Radiology

    Background:

    • Recurrent pulmonary embolism (PE) leads to progressive pulmonary vascular obstruction.
    • This obstruction causes pulmonary arterial hypertension (PAH), right ventricular hypertrophy, and failure.
    • Early stages present with subtle symptoms, complicating diagnosis.

    Purpose of the Study:

    • To review the diagnostic challenges and methods for recurrent pulmonary embolism.
    • To describe the anatomical and clinical manifestations of recurrent PE.
    • To outline the diagnostic contributions of various imaging and physiological tests.

    Main Methods:

    • Review of anatomical obstruction in pulmonary arteries.
    • Analysis of early clinical manifestations and symptoms.

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  • Evaluation of diagnostic utility of chest roentgenogram, electrocardiogram, arterial blood gas analysis, pulmonary perfusion scintigraphy, and pulmonary angiography.
  • Assessment of pulmonary arterial hypertension via catheterization.

    • Main Results:

    • Recurrent PE obstructs main pulmonary artery branches in most cases.
    • Initial symptoms are often atypical (dyspnea, tachycardia, chest pain, hemoptysis, fever).
    • Diagnostic yield: chest X-ray (20%), ECG (10%), arterial blood gases (significant findings), perfusion scan (50%), angiography (80-90%).
    • Pulmonary hypertension may be inconstant, appearing during stress.

    Conclusions:

    • Recurrent PE diagnosis is difficult due to subtle early signs.
    • Pulmonary angiography is the most effective imaging modality.
    • Progression to right heart failure can be rapid once right ventricular hypertrophy occurs.