ORIGINAL: How to Improve the Clinical Suspicion of Pulmonary Embolism in Hospitalized Patients Pages 70-74

Antonio Gómez-Valdés1, Rene Mora2 and Manuel Viamonte Jr.3

1Department of Internal Medicine, Havana University School of Medicine, USA; 2Department of Peripheral Vascular Surgery, Pan American Hospital Miami Florida, USA; 3Department of Radiology, Florida International University, School of Medicine, USA

DOI: http://dx.doi.org/10.12970/2311-052X.2016.04.02.5

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Abstract: Background: The high number of missed diagnosis of pulmonary embolism antemortem still has not improved.
Objective: To define the causes of misdiagnosis and suggest another way in order to increase the rate of clinical suspicion.

Material and Methods: The cases with autopsy-confirmed of PE from 32986 autopsies were studied retrospectively. The data was classified according to the useful points to investigate the causes of undiagnosed antemorten.
Results: The number of patients that had the diagnosis suspected of PE antemorten was 692 (24.2 %). The dominant cause of misdiagnosis was deficient clinical suspicion (26.4 %). The underlying conditions that most frequently cause unsuspected PE were heart disease 24.6 % (mainly myocardial infarction), pneumonia (23 %) and cancer (15.1 %). Altogether, the percentage of correct clinical diagnosis of PE was 26.9 % (95 % CI).

Conclusions To increase the rate of correct diagnosis of PE, it is necessary to perform the clinical suspicion in the atypical forms that are common, besides the classical markes used.

Keywords: Pulmonary embolism, clinical suspicion, anxiety, sudden dyspnea.
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