CHEST RADIOGRAPHS IN ACUTE PULMONARY EMBOLISM
AbstractBackground: Pulmonary embolism (PE) is a serious clinical entity carrying significant morbidityand mortality. Clinically, it is a difficult condition to diagnose and remains under treated conditionin Pakistan due to non-availability of objective tests and lack of awareness among physicians. Thisstudy was conducted to determine the chest radiographic presentation in known cases of acute PEpresenting to a tertiary care hospital. Methods: Hospital records of patients with a diagnosis ofacute PE were reviewed from June 2000 until June 2004. Fifty diagnosed cases of acute PE onSpiral Computed tomography (CT) of the chest demonstrating an intraluminal-filling defect wereselected. Two chest physicians reviewed the chest radiographs obtained during thathospitalization. In case of discrepancy, a radiologist made final interpretation. Results: The chestradiograph was interpreted as normal in only 18% of patients with acute PE. The most commonchest radiographic abnormalities were cardiac enlargement (38%), pulmonary parenchymalinfiltrates (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 radiographicabnormality associated with acute pulmonary embolism. Chest radiography is not useful inmaking the diagnosis of acute pulmonary embolism. Its major role is in identification ofalternative disease processes that can mimic thrombo-embolismKeywords : Chest radiograph, Echocardiography, Pulmonary embolism
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