[Pulmonary hypertension in acute pulmonary embolism]

Twenty-five patients with acute pulmonary embolism without other pulmonary or heart diseases were analyzed for pulmonary hypertension. Doppler echocardiography was used to determine the systolic pressure of the pulmonary artery (PAPs) from the maximal velocity of the tricuspid regurgitation using corrected Bernoulli's formula (PAPs = 1.23 x 4 Vmax2 - 0.09). Pulmonary hypertension was found in 84% (21/25) of the patients with acute pulmonary embolism. PAPs values ranged between 34 and 90 mmHg (X = 54 +/- 7.5 mmHg) and hypocapnia with carbon dioxide partial pressure, PaCO2, ranged from 26 to 34 mmHg (X = 30 +/- 2 mmHg). PAPs showed a significant negative correlation with oxygen partial pressure (r = -0.87, P < 0.01). According to the findings of lung scintigraphy, all patients with pulmonary hypertension had submassive pulmonary embolism with perfusion abnormalities in two segments (X = 5 +/- 2 segments). It is concluded that pulmonary hypertension may be expected in more than 80% of the patients with submassive acute pulmonary embolism, and hypoxemia and hypocapnia. Doppler echocardiography is a noninvasive method useful in the diagnosis and follow-up of pulmonary hypertension in patients with acute pulmonary embolism.