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Pulmonary embolism associated with acute stroke

E F Wijdicks1, J P Scott

  • 1Department of Neurology, Mayo Clinic Rochester, MN 55905, USA.

Mayo Clinic Proceedings
|April 1, 1997
PubMed
Summary

Pulmonary embolism (PE) is a serious complication following stroke, often occurring weeks later. Half of stroke patients with PE die suddenly, highlighting the need for better diagnosis and prevention strategies.

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Area of Science:

  • Neurology
  • Cardiology
  • Pulmonology

Background:

  • Pulmonary embolism (PE) is a significant risk following acute stroke.
  • Understanding the specific circumstances, prophylaxis, and outcomes of PE in stroke patients is crucial for improving patient care.

Purpose of the Study:

  • To investigate the clinical characteristics of pulmonary embolism in patients who have experienced a stroke.
  • To evaluate the prophylactic measures employed and the outcomes for stroke patients who develop pulmonary embolism.

Main Methods:

  • A retrospective review of medical records was conducted for 30 patients diagnosed with pulmonary embolism after acute stroke at Mayo Clinic Rochester over a 20-year period.
  • Pulmonary embolism was confirmed through pulmonary angiograms, ventilation-perfusion scans, or autopsy findings.

Main Results:

  • Pulmonary embolism occurred between 3 and 120 days post-stroke (median 20 days).
  • Sudden death was observed in 50% of patients (15 out of 30).
  • Deep venous thrombosis (DVT), often in the paralyzed leg, was associated with PE in 11 patients; only 4 patients received DVT prophylaxis.

Conclusions:

  • Pulmonary embolism in stroke patients can be difficult to diagnose before death in approximately half of cases.
  • PE represents a cause of early mortality in stroke patients, particularly within the first month after the ictus.

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