Abstract
Purpose: Chest radiography is normal in approximately 20-40% of acute pulmonary embolism (PE) patients without cardiopulmonary disease. The aim of this study was to determine whether there is any difference between the patients with normal chest X-ray and those with pathological findings in terms of clinical severity and prognosis. Methods: 178 of PE patients were included in the study. 110 patients had no parenchymal pathology, whereas group 1 (n = 110); group 2 (n = 68) had various pathological parenchymal findings in 68 patients. Clinical and radiological parameters were compared between these groups. Following the diagnosis of PE, the cases were recorded in the fifth year. Results: In 178 participants; those with normal chest X-ray (group 1), with parenchymal pathological findings on the chest X-ray (group 2); echocardiographic systolic pulmonary artery pressure (sPAP) (p = 0.68), gender (p = 0.9) and thrombus type (p = 0.41) were similar. The patients in group 1 were not different in terms of central thrombus detected in computed tomography pulmonary angiogram compared to the patients in group 2; however, the chest radiograph of the patients in group 1 had no parenchymal pathology. Central thrombus group 1, group 2, respectively; 97 (89.0%), 53 (77.9%), p = 0.07. There was no significant difference between the two groups in terms of mortality which was followed up in fifth year (p > 0.05). Conclusions: Normal chest X-ray in PE can determine mortality and may involve increased risk of massive PE.
Highlights
Pulmonary embolism (PE) occurs mostly because of thrombus originating from lower extremity deep venous thrombosis
We aimed to investigate whether there is a difference in terms of clinical severity and prognosis between
In our hospital registry system, chest X-ray and CTPA scans were analyzed by one radiologist who was blinded to the original Computed tomography (CT) report and patients’ diagnosis
Summary
Pulmonary embolism (PE) occurs mostly because of thrombus originating from lower extremity deep venous thrombosis. PE should be suspected especially in patients who presented with dyspnea and tachycardia and whose chest X-ray was normal and could not be explained by another disease. In clinical cases suspected from PE, Wells clinical scoring is performed. Wells score 2 and above; are considered as medium and high-risk cases. Chest X-ray findings can be subsegmental atelectasis, pleural-based opacity (Hampton hump), pleural effusion, diaphragm elevation, pulmonary artery enlargement, sudden vascular discontinuation, right ventricular dilatation, local vascular reduction, and transparency (Westermark sign). These findings are not specific to PE [1]-[3]. It was shown that there was no significant difference between the patients with and without PE [4]
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