Simple Signs for Complex Problem

Abstract

Objectives: To find simple clinical signs for diagnosing pulmonary embolism on bedside.

Methodology: This was a hospital based cross sectional observational study conducted in cardiology department Saidu teaching hospital from July 2019 to December 2020. 89 patients of either sex and all age groups with suspected pulmonary embolism (PE) were included. Clinical data and basic tests of all these patients were obtained, then according to ESC diagnostic algorithm patients were divided into low, intermediate and high probability groups. 74 patients with intermediate and high probability went for CTPA, while 15 patients with low probability were exclude from study. In 67 patients pulmonary embolism was confirmed on CTPA. Clinical data of these 67 patients was analyzed for most common presenting symptoms and signs.

Results: Data was available on 67 patients with confirmed PE, 58.2% were male and 41.8% were female. Mean age of study population was 53.15+/-16.29. Patients from different parts of Malakand division were included. 95.5 % patient presented with new onset dyspnea, 1.5 % presented with isolated chest pain, while 3% presented with other symptoms. 62.7 % patient had provoked and 37.3% had unprovoked PE. Mean heart rate of study population was 99.63. 95% patients had oxygen saturation of less than 96%. Other common findings included normal chest examination, sinus tachycardia on ECG, normal chest X-ray, and some form of right ventricular abnormality on Echo.

Conclusion: Patient with new onset Dyspnea, resting Tachycardia, oxygen saturation below 95% at rest or mild exertion, and no other explanation for these findings should be evaluated for pulmonary embolism with CTPA.