Application value of ultrasound in patients with pulmonary embolism combined with coronary heart disease

Abstract

Objective To discuss the application value of transthoracic echocardiography (TTE) and lower extremity deep venous ultrasonography in patients of pulmonary thromboembolism (PTE) combined with coronary heart disease (CHD). Methods Nine hundred and seventy-four hospitalized patients of PTE in the first hospital of China medical university between December 2010 and March 2015 was enrolled, 119 cases of these were combined with CHD (12.22%), including 94 cases of unstable angina and 25 cases of myocardial infarction. To review the general information, embolism area and ultrasonic report of the patients of PTE combined with CHD. The patients were divided into two groups according to whether they were combined with left ventricular systolic or diastolic dysfunction or valvular diseases. To compare TTE parameters between the two groups with two-sample t-test and calculate the sensitivity and specificity of diagnosing imaging massive pulmonary embolism (MPE) by TTE. Results (1) Seventeen cases thrombosis (3.43%) were observed in PTE patients who underwent TTE. The majority were pulmonary artery thrombosis (11 cases). Four cases of thrombosis (5.63%) were observed in PTE patients combined with CHD. The majority were right heart embolus (3 cases). (2) Lower extremity deep venous thrombosis (LEDVT) was observed in 52.60% of all the PTE patients and 34.62% of PTE patients combined with CHD. The majority were on the left and the deep venous thrombosis of the calf. (3) Fouty-six cases (64.79%) were PTE indirect signs in TTE. The sensitivity of echocardiography diagnosis of MPE was 84.38% and the specificity was 52.60%. (4) Pulmonary arterial systolic pressure [(47.90±21.49) mmHg vs (31.18±22.43) mmHg (1 mmHg=0.133 kPa), t=3.227, P<0.05] and inferior caval vein diameter [(19.66±4.41) mm vs (16.20±3.46) mm, t=3.598, P<0.05] in CHD combined with left ventricular systolic or diastolic dysfunction or valvular heart disease were higher than the control group. The differences were statistically significant. Conclusions The proportion of CHD in hospitalized PTE patients was high. TTE could find PTE signs and had high sensitivity for diagnosis of MPE. TTE could prompt the possibility of PTE combined with left heart disease. Key words: Coronary disease; Pulmonary embolism; Echocardiography