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 1 st 2014 to April 30 th 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 lo-cated, 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. S 1 Q 3 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.

[1]  B. F. E. Mbolla Aspects échocardiographiques et scannographiques au cours de l'embolie pulmonaire aiguë dans le service de cardiologie du CHU de Brazzaville (Congo) , 2019 .

[2]  D. Pateron,et al.  Embolie pulmonaire , 2019, Mega-Guide Pratique des Urgences.

[3]  M. Ndiaye,et al.  La mort subite de l’adulte, particularités en Afrique, à propos de 476 cas , 2013, The Pan African Medical Journal.

[4]  V. Olié,et al.  La maladie veineuse thromboembolique : patients hospitalisés et mortalité en France en 2010 , 2013 .

[5]  Y. Afassinou,et al.  Cardiovascular Risk Factors in Black African Obese Patients: A Multicentric Comparative Study in 1512 Patients in Lome (Togo) , 2013 .

[6]  M. Pio,et al.  Actualité sur la maladie thromboembolique veineuse au CHU Sylvanus Olympio de Lomé , 2013 .

[7]  F R Rosendaal,et al.  The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study , 2009, BMJ : British Medical Journal.

[8]  P. Sandset,et al.  D-dimer level is associated with the extent of pulmonary embolism. , 2007, Thrombosis research.

[9]  I. Mahé,et al.  L’âge, un facteur indépendant de risque de thrombose: Données épidémiologiques , 2005 .

[10]  B. Lambert L' embolie pulmonaire en pratique clinique : à propos de 839 cas consécutifs en hôpital général : étude STEP , 2003 .

[11]  F. Simon,et al.  [Cardiovascular diseases and HIV infection: study of 79 cases at the National Hospital of Ouagadougou (Burkina Faso)]. , 2002, Bulletin de la Societe de pathologie exotique.

[12]  B. Planchon,et al.  Facteurs de risque et incidence de la maladie thromboembolique veineuse en médecine interne : une étude descriptive prospective sur 947 patients hospitalisés , 2001 .

[13]  A. Noseda,et al.  Diagnostic de l'embolie pulmonaire , 1999 .

[14]  A. Adoh,et al.  Facteurs étiologiques des thromboses veineuses profondes des membres chez le sujet noir Africain , 1992 .