Clinical profile of patients presenting with acute pulmonary thromboembolism in a tertiary care hospital in India: A retrospective study

Objective: To study the clinical profile in patients with acute pulmonary embolism. Methods: Retrospective study of clinical profile and management of patients presenting with acute pulmonary embolism from January 2015 to January 2016. Results: 53 patients who were newly diagnosed to have acute pulmonary thromboembolism with a mean age of 47.2 years with 91% being males were included in the study. It was found that majority of the patients had atleast 1 risk factor for embolisation(58.5%) with smoking being the most important risk factor. Dyspnea (71.7%) and syncope (17.0%) were the predominant symptoms. 39.6% patients had tachycardia and 22.6% had hypotension. Echocardiography was done in all patients. 45 patients (84.9%) had pulmonary arterial hypertension, 31 patients (58.4%) had evidence of RA/RV dysfunction and 3 patients (5.7%) had evidence of thrombus in heart. CT pulmonary angiogram was done in all patients. 32(60.3%) patients underwent anticoagulataion with unfractionated heparin, 10(18.7%) patients were thrombolysed and 6(11.3%) patients underwent embolectomy. 5 patients underwent both thrombolysis and anticoagulation. However independent of the mode of treatment, most patients had good treatment outcomes with the mortality rate being only 7.5%. Conclusion: Pulmonary embolism can have multiple presentations in terms of clinical symptoms, signs and investigations. Early diagnosis and aggressive management is the key to successful outcome.