Contribution of Diagnosis Examinations in Pulmonary Embolism

Background: We aimed to determine the specificities of pulmonary embolism (PE) investigations and their statistical link according to PE’s degrees of severity. Patients and Methods: It was a cross-sectional study on patient- records admitted in Cardiology Department for PE, from June 1st 2014 to April 30th 2019. We studied electrocardiogram (ECG), Chest X-ray, Echocardiographic, D-dimers, CT pulmonary angiographic (CTPA) data. PE diagnosis was retained at the CTPA. PE was classified according to its severity (low, intermediate, and severe). Patients were arbitrarily categorized in 4 groups (G1 - G4) according to D-dimer level. Results: We retained 110 patient- records of patients mean aged 56 ± 15 years, with female predominance (Sex-ratio F/M = 1.82). Patients with main pulmonary artery’s (MPA) embolism had D-dimer value > 5000 ng/mL. The more proximal embolism was located, the higher D-dimer level was, but no significant association was found between D-dimer level and PE’s severity. CTPA showed bilateral location of embolism in 52% of cases. Severe PE (SPE) was significantly associated to proximal location (main and segmental branches of PA), and repolarization disorders. S1Q3 aspect was associated to intermediate mortality risk PE. On chest X-ray, cardiomegaly and the left middle arch convexity were associated to SPE. PAH was significantly associated to SPE. Conclusion: PE, serious disease has the diagnostic challenge according to its clinical presentations. Several findings of PE investigations should be useful for SPE assessment in our areas, especially since CTPA is not often accessible, even in urban cities.