Incidence of Pulmonary Embolism in the ED

From the International Fluid Academy:

AUTHORS’ CONCLUSIONS

  • PE was confirmed in 1/6 (17%) of adult patients hospitalised for a first episode of syncope, not on anticoagulant treatment
  • Although an even higher PE prevalence of 25% was noted in the subgroup with syncope of undetermined origin, also almost 13% of patients considered having another clinical explanation for the syncope had PE.
  • Syncope due to PE is thought to occur because of a sudden obstruction of the most proximal pulmonary arteries that lead to a transient depression in cardiac output. However, in approximately 40 % of the confirmed PE cases the vascular obstruction was “small” (<25% perfusion defect on VQ scan or most proximal location of embolus in (sub)segmental artery). This suggest there might be other associated mechanisms responsible for the syncope.

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