CHEST RADIOGRAPHS IN ACUTE PULMONARY EMBOLISM
Abstract
Background: Pulmonary embolism (PE) is a serious clinical entity carrying significant morbidityand mortality. Clinically, it is a difficult condition to diagnose and remains under treated condition
in Pakistan due to non-availability of objective tests and lack of awareness among physicians. This
study was conducted to determine the chest radiographic presentation in known cases of acute PE
presenting to a tertiary care hospital. Methods: Hospital records of patients with a diagnosis of
acute PE were reviewed from June 2000 until June 2004. Fifty diagnosed cases of acute PE on
Spiral Computed tomography (CT) of the chest demonstrating an intraluminal-filling defect were
selected. Two chest physicians reviewed the chest radiographs obtained during that
hospitalization. In case of discrepancy, a radiologist made final interpretation. Results: The chest
radiograph was interpreted as normal in only 18% of patients with acute PE. The most common
chest radiographic abnormalities were cardiac enlargement (38%), pulmonary parenchymal
infiltrates (34%), atelectasis (26%), pleural effusion (24%), and pulmonary congestion (24%).
Other rare findings were elevated hemi diaphragm (14%), pulmonary artery enlargement (14%),
and focal oligemia (8%). Conclusions: Cardiomegaly is the most common chest radiographic
abnormality associated with acute pulmonary embolism. Chest radiography is not useful in
making the diagnosis of acute pulmonary embolism. Its major role is in identification of
alternative disease processes that can mimic thrombo-embolism
Keywords : Chest radiograph, Echocardiography, Pulmonary embolism
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