PULMONARY EMBOLISM: A COMMONLY MISSED CLINICAL ENTITY.

SUMMARY Twelve per cent (118 cases) of all consecutive necropsies in a large general hospital during a five-year period (1956-1960) were found to have pulmonary emboli. The charts and necropsy protocols of these patients were reviewed and pertinent data abstracted. As has been previously noted, there was a high incidence of cardiovascular disease, malignancy and surgical procedures in these patients. The signs, symptoms and presenting syndromes were essentially the same as those already reported. In spite of this, the antemortem diagnosis of pulmonary embolism was made in only 9 per cent of the entire group. The finding of multiple embolic phenomena of various ages in which embolization was fatal implies that the eventual demise from this disease might have been prevented if the early diagnosis could have been made and effective treatment instituted. It is felt, therefore, that the cardinal signs and symptoms should be carefully sought, particularly in those patients who constitute the highest risk group. Perhaps the early treatment of these patients with anticoagulant drugs, as well as other supportive measures, may reduce the overall mortality of this disease.