Document Type : Original Article
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Faculty of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
Background: Acute pulmonary thromboembolism (PTE) is a common condition with an increasing incidence that causes severe complications and death. We herein describe the clinical profile of patients with PTE who were referred to a large tertiary university heart hospital.
Methods: In this retrospective cohort study, the demographic, clinical, and admission data of patients with PTE admitted to Rajaie Cardiovascular Medical and Research Center in 2 consecutive years were reviewed and analyzed. Based on echocardiography findings, clinical presentation, and pulmonary computed tomography findings, the patients were divided into massive, submassive, and minor PTE groups. The study variables, as well as in-hospital mortality, were compared between the groups.
Results: The study population consisted of 328 patients with PTE: 210 patients (64.0%) with ordinary PTE, 88 (26.8%) with submassive PTE, and 30 (9.1%) with massive PTE. The patients with massive PTE were significantly younger (P=0.007) and had a higher rate of tachypnea (P=0.002), tachycardia (P=0.013), and hypotension (P<0.001) at presentation. The patients with submassive PTE were more likely to be male and had higher uric acid levels (P=0.002). Chest pain and hypertension were more frequent in the patients with ordinary PTE (P=0.019 and P=0.016, respectively). In pulmonary computed tomography angiography, the involvement of the left and right pulmonary arteries was more frequently observed in the patients with submassive PTE (P=0.013 and P=0.007, respectively). More patients in the massive PTE group received thrombolytic therapy (P<0.001) with a significantly higher mortality rate (P<0.001), a shorter ICU stay (P=0.001), and a shorter hospitalization period (P<0.001).
Conclusions: Patients with massive PTE have a higher risk of mortality and should be considered for more aggressive therapy. (Iranian Heart Journal 2022; 23(1): 95-105)