Abstract
The risk of pulmonary thromboembolism (PTE) in patients with exacerbated chronic obstructive pulmonary disease (e-COPD) is higher than in non-COPD states. This study aimed to evaluate the prevalence and the parameters that are critical for finding the incidence of PTE in patients with e-COPD. This cross-sectional study was performed on 68 consecutive patients with the e-COPD, referred to the Pulmonary Disease Department at the Shariati Hospital in Tehran between 2013 and 2014. In addition to collecting data on the history of disease and physical examination, arterial blood sampling, spirometry, electrocardiography and echocardiography were performed for all patients. All patients underwent the computed the tomography pulmonary angiography (CT-PA) as a method of choice for diagnosing PTE. Out of 68 cases (7.4%), five were had CT angiography findings suggesting PTE. These patients were all male and had a higher mean age (79 vs. 65 years), lower mean systolic blood pressure (88.36 vs. 118.33 mmHg), and a higher mean heart rate (133.12 vs 90.33 beats/min), compared to e-COPD patients without PTE. Arterial blood gas analysis in patients with PTE demonstrated a lower HC03 (2.33 vs. 9.44 mEq/l) and PC02 (44.35 vs. 51.43 mmHg) levels. The mean LVEF was lower in patients with PTE (34.14 ±4.49% vs. 46.94 ± 8.27%). The prevalence of PTE in our series of patients with e-COPD was 7.4%. According to the study results, male gender, advanced age, hypotension, tachycardia, and respiratory alkalosis are factors indicating possible PTE among patients with e-COPD.
Highlights
The risk of pulmonary thromboembolism (PTE) in patients with exacerbated chronic obstructive pulmonary disease (e-COPD) is higher than in non-COPD states
Parameters, including the patient’s age and mean heart rate were significantly higher in subjects with PTE compared with the other group
The two groups were statistically different in terms of diastolic blood pressure, arterial O2 saturations before or after receiving nasal oxygen, FEV1, FVC, pulmonary artery pressure (PAP), or mitral valve regurgitation
Summary
The risk of pulmonary thromboembolism (PTE) in patients with exacerbated chronic obstructive pulmonary disease (e-COPD) is higher than in non-COPD states. Results: Out of 68 cases, five (7.4%) had CT angiography findings suggesting PTE. These patients were all male and had a higher mean age (79 vs 65 years), lower mean systolic blood pressure (88.36 vs 118.33 mmHg), and a higher mean heart rate (133.12 vs 90.33 beats/min), compared to e-COPD patients without PTE. Because of their frequent concomitant occurrence, there are no proven clinical criteria to help delineate PTE from COPD [3]. This is attributable to the overlapping clinical features and the non-specificity of the signs and symptoms of both conditions [4]. Unlike e-COPD, which is recognized clinically, imaging studies are required to confirm the diagnosis of PTE [5]
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