AI Summary & Key Takeaways
AI InsightPerfusion defects were found by perfusion lung scan in 5 cases Perfusion de- fect was found in 5 (10.2%) of 6 patients from whom we obtained perfusion lung scan.Warfarin treatment was instituted in 41 (83.7%) patients, LMWH was given to 8 (16.3%) patients.
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Abstract
Pulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance (thrombus) that has travelled from the deep veins in the legs. Pulmonary embolism is one of the difficult diagnoses with high mortality rates in medicine practice. The diagnosis however, can be difficult due to the atypical presentation. We aimed to evaluate demographic characteristics, clinical, laboratory and radiological findings of 49 pulmonary embolism cases who had been diagnosed in our hospital between January 2009-January 2010. The mean age of the patients was 61.08 ± 17.20 years, and 28(%57.1)of them were female and the others were male(42.9%). Twenty-five (51%) cases had risk factors. All cases were symptomatic. The most frequent symptoms were dyspnea and chest pain .The mean symptom duration was12.02±25.2 days. In radiological examinations, elevation of diaphragm (n= 32, 65.3%), lineer atelectasis (n=19, 39%) were the predominan features. 7 (14.3%) patients’ X-rays were normal.18 (36.7%) patients had right hearth dilatation on echocardiography. In arterial blood gases samples,most frequent anormality was hypoxia and hypocapnia. Thrombosis was detected by 64 multislice thorax spiral CT in 43 of 45 with PE. Perfusion defects were found by perfusion lung scan in 5 cases Perfusion de- fect was found in 5 (10.2%) of 6 patients from whom we obtained perfusion lung scan.Warfarin treatment was instituted in 41 (83.7%) patients, LMWH was given to 8 (16.3%) patients.
Özet
Pulmoner emboli alt ekstremite derin venlerinden kopan trombüslerin pulmoner arter ve dallarını tıkaması ile oluşan klinik bir durumdur. Oldukça sık karşılaşılan, zor tanı konulan ve mortalitesi yüksek pulmoner acil olguların başında gelmektedir. Nonspesifik belirti ve bulguları nedeni ile tanısı zor olabilir. Bu çalışmada; Ocak 2009-Ocak 2010 tarihleri arasında merkezimizde pulmoner emboli tanısı konmuş 49 olgunun demografik özellikleri, klinik, laboratuar ve radyolojik bulgularını değerlendirmeyi amaçladık.Olguların yaş ortalaması 61.08 ± 17.20 yıl olup; 28 (%57.1)’i kadın, 21 (%42.9)’i erkekti. Yirmibeş (%51) olguda risk faktörü mevcut idi. Olguların hepsi semptomatik idi. En sık semptomlar nefes darlığı ve göğüs ağrısı idi. Ortalama semptom süresi 12.02±25.2 gün olarak bulundu. Akciğer grafisinde 32 olguda diyafragma yükselmesi (%65.3) ve 19 olguda atelektazi (%39) saptandı. 7 olgunun (%14.3) PA akciğer grafisi normaldi. 18(%36.7) olguya ekokardiyografik inceleme yapıldı.13 (%26.5) olguda pulmoner arteriyel hipertansiyon saptandı. Arter kan gazı analizlerine göre olgularda en sık hipoksi ve hipokapni saptandı. 4 kesitli Spiral Toraks BT Anjiografi çekilen 45 olgunun 43’ünde(%87.8) ana ve/veya segmental-subsegmental pulmoner damarlarda trombus saptandı. Perfüzyon sintigrafisi çekilen 6 (%12.2) olgunun 5’inde (%10.2) perfüzyon defekti saptandı Olguların 41’ine (%83.7) warfarin tedavisi uygulanırken, 8 ‘ine (% 16.3)düşük molekül ağırlıklı heparin (DMAH) tedavisi uygulandı.