[Clinical features of acute pulmonary embolism in the elderly]

The clinical features of acute pulmonary embolism were evaluated and compared between Group A with 38 cases > 65 years old and Group B with 73 cases < 65 years old. The mortality rate was 58% (22/38) in Group A and 23% (17/73) in Group B (p < 0.01). However the size of the obstructive pulmonary vascular bed showed no significant difference in both groups. In group A dyspnea was the most common symptom in 27 of 31 (87%), in comparison with group B [45 of 66 (68%), p < 0.05]. In group B, dyspnea and other symptoms appeared abruptly in 44 of 57 (77%), compared with 19 of 36 (53%) in group A (p < 0.02). ECG abnormalities including tachycardia, right bundle branch block and clockwise rotation as well as hypoxemia were present more predominantly in group A. The presentation of pulmonary embolism is variable in the elderly, as in any age group. Many autopsy studies showed a significant rise in incidence of pulmonary embolism in higher age groups. We must keep in mind the characteristics of clinical features in pulmonary embolism in the elderly.