Clinical studyValue of transthoracic echocardiography in the diagnosis of pulmonary embolism: results of a prospective study in unselected patients☆
Section snippets
Patient population
The study population consisted of 125 consecutive patients referred to our institute because of suspected PE from February 1 through December 31, 1997. In 15 (12%) of these 125 patients, the echocardiographic study could not be completed because of a poor acoustic window. The following is the report of the results obtained from the 110 patients in whom the echocardiographic study was completed. All patients were examined uniformly according to a standardized protocol described below.
Clinical evaluation
Upon study
Patient characteristics and prevalence of PE
The mean age of the 110 patients who had been referred for lung scanning with clinically suspected PE was 63.8 ± 17.2 years (range 15 to 91); 45 of them (41%) were male. Most—79 of 110, or 72%—were hospitalized at the time of study entry. The median time between onset of symptoms and study entry was 1 day (range 0 to 30).
Table 1shows the classification of patients according to clinical probability and perfusion lung scan results. Lung scans were normal or near-normal in 34 (31%) of the 110
Discussion
Over the last decade, there has been growing interest in using transthoracic echocardiography in the noninvasive diagnostic work-up of patients with suspected PE 12, 13, 14, 25. The contribution of echocardiography to the diagnosis of PE is most often indirect because visualization of right-sided heart emboli is a relatively rare occurrence. In fact, in the International Cooperative Pulmonary Embolism Registry (ICOPER), intracardiac thrombi were visualized in only 45 (4%) of 1,135 patients
Acknowledgements
The authors wish to thank Drs. Germana Allescia, Carolina Bauleo, Laura Carrozzi, Giosuè Catapano, Alba Dainelli, and Luigi Rizzello for their help in the clinical evaluation of patients; Giuseppe Maltinti, Claudio Mazzotti, Loredana Salis, Armando Perissinotto, Alberto Pollastri, and Nilo Faraoni for their excellent technical assistance; and Prof. Anthony L. Johnson for reviewing the manuscript.
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Supported in part by the Ministry of Health and the Ministry of University and Scientific and Technological Research of Italy.