scholarly journals D-dimer negative pulmonary embolism

2018 ◽  
Vol 5 (2) ◽  
pp. 429
Author(s):  
Dhananjaya M. ◽  
Kirankumar Meti ◽  
Rajendrakumar Parakh
Keyword(s):  
Pulmonary Embolism ◽  
Tertiary Care ◽  
Safety Margin ◽  
Final Diagnosis ◽  
Pulmonary Angiography ◽  
Clinical Suspicion ◽  
Care Hospital ◽  
Ct Pulmonary Angiography ◽  
The Mean ◽  
D Dimer

Background: Pulmonary embolism (PE), is one of the major cardiovascular causes of death. Pulmonary embolus (PE) can be fatal but is often treatable if recognized early. Unfortunately, the clinical presentation of PE is often variable and misleading mimicking other illnesses and hence known as "the Great Masquerader," making diagnosis difficult. The D-dimer assay has recently come into favour as a method to exclude PE; however, this test has an acceptable safety margin only in low-risk populations.Methods: Present study included 35 patients with clinical suspicion of pulmonary embolism admitted at the tertiary care hospital of North Karnataka during the period from October 2016 to September 2017. Patients were classified according to final diagnosis by CT Pulmonary Angiography into 28 cases positive for PE (80%) and 7 cases negative for PE (20%).Results: Present study included 35 cases suspected to have PE (26 males and 9 females). Their age ranged from 33 to 72 years, with a mean age 48.9 ±14.2 years. 28 cases positive for PE (80%) and 7 cases negative for PE (20%). The mean age of positive and negative PE cases was 48.1±11.2 and 46.4±8.8 respectively. Results of D-dimer test were positive in 10 cases (35.7%) and were negative in 18 cases (61.3 %) of PE.Conclusions: This report highlights the risk of misdiagnosing PE if relying solely on ELISA D-dimer for exclusion. This report documents the presentation of PE despite having unremarkable ELISA D-dimer measurements and highlights the importance of clinical suspicion.

scholarly journals Pulmonary thromboembolism in COVID-19 Patients on CT Pulmonary Angiography - A Single-Centre Retrospective Cohort Study in the United Arab Emirates

2021 ◽  
Author(s):  
Ghufran Aref Saeed ◽  
Waqar Haider Gaba ◽  
Abd Al Kareem Mohd Adi ◽  
Reima Obaid Al Marshoodi ◽  
Safaa Saeed Al Mazrouei ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
United Arab Emirates ◽  
Pulmonary Thromboembolism ◽  
Pulmonary Angiography ◽  
Rt Pcr ◽  
Ct Pulmonary Angiography ◽  
Exclusion Criteria ◽  
The Mean ◽  
Positive Groups ◽  
D Dimer

Purpose. Our aim is to identify the prevalence and distribution of pulmonary thromboembolism in COVID-19 infected patients in our hospital. Materials and Methods. Data of all patients with COVID-19 infection either on RT-PCR testing or non-contrast high resolution CT(HRCT) who had CT pulmonary angiography (CTPA) from April to June 2020 were included. 133 patients were initially included in the study, 7 were excluded according to exclusion criteria, leaving a total number of 126 patients. Results. Twenty (15.8%) patients had evidence of pulmonary embolism (PE) on CTPA with mean age of 50 years (range 31-85) of which 95% were males. The mean D-dimer was 5.61mcg/mL among the PE-negative and 14.49 mcg/mL in the PE-positive groups respectively. Among the patients with evidence of pulmonary embolism on CTP, almost half required admission to intensive care unit in comparison to only one-fifth with negative CTPA. One-fourth died among the PE positive group with only 5% died among the PE negative group. There was a 33% reduction in the development of PE in the COVID-19 patients who had received low molecular weight heparin (LMWH) prior to their CTPA study versus those who had not. Conclusion. D-dimer correlates well with the incidence of pulmonary embolism among COVID-19 patients. Our data suggest that majority of our patients, developed pulmonary embolisms within 5 days into their hospital stay, accounting to almost two thirds of all positive cases diagnosed by CTPA. Those with PE among COVID-19 patients have high chances of ICU admission and mortality. Use of thromboprophylaxis early on might reduce the incidence of PE.

scholarly journals CT pulmonary angiography in COVID-19 pneumonia: relationship between pulmonary embolism and disease severity

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aya Yassin ◽  
Maryam Ali Abdelkader ◽  
Rehab M. Mohammed ◽  
Ahmed M. Osman
Keyword(s):  
Pulmonary Embolism ◽  
Disease Severity ◽  
Laboratory Data ◽  
Pulmonary Angiography ◽  
Significant Relation ◽  
Ct Pulmonary Angiography ◽  
Laboratory Results ◽  
Severity Of The Disease ◽  
The Relationship ◽  
D Dimer

Abstract Background Pulmonary embolism (PE) is one of the known sequels of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory indicators. This was a retrospective study conducted on 96 patients with COVID-19 infection proved by positive PCR who underwent CT pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patients’ complaint and laboratory data at the time of CTPA were correlated with PE presence and disease severity. Results Forty patients (41.7%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex, laboratory results, and the CT severity of COVID-19. A statistically significant relation was found between the incidence of PE and the patients’ desaturation, hemoptysis, and chest pain. A highly significant correlation was found between the incidence of PE and the rising in the D-dimer level as well as the progressive CT findings when compared to the previous one. Conclusion CT progression and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and alert the use of CT pulmonary angiography to exclude or confirm PE. This is may help in improving the management of COVID-19 infection.

scholarly journals CORRELATION OF D-DIMER LEVEL WITH THE PRESENCE AND SEVERITY OF PULMONARY EMBOLISM ON COMPUTED TOMOGRAPHY PULMONARY ANGIOGRAPHY

2020 ◽  
pp. 33-34
Author(s):  
Mantavya Patel ◽  
Sanjay Paliwal ◽  
Rachit Saxena
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Early Diagnosis ◽  
Pulmonary Angiography ◽  
Clinical Suspicion ◽  
Early Prediction ◽  
Computed Tomography Pulmonary Angiography ◽  
Negative Prediction ◽  
D Dimer

Introduction: Early diagnosis of pulmonary embolism can reduce morbidity and motility. D-dimer is well known parameter having high negative prediction value. This study focused on role of D-dimer in early prediction of presence and severity of pulmonary embolism. Material and Methods: Thirty patients with clinical suspicion of pulmonary embolism along with high D-dimer value were included in this study. All selected patients underwent computed tomography pulmonary angiography assessment. D-dimer value was correlated with presence and proximity of pulmonary embolism. Results: Out of thirty selected patients 50% had pulmonary embolism on computed tomography pulmonary angiography assessment. D-dimer value correlated well with presence and proximity of pulmonary embolism. Conclusion: D-dimer value more than 4000 ng/ml had high positive prediction value (79%) in suspected clinical cases. Value more than 8000 ng/ml further improve value to nearly 100% in suspected cases.

scholarly journals Investigation of Suspected Pulmonary Embolism at Hutt Valley Hospital with CT Pulmonary Angiography: Current Practice and Opportunities for Improvement

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Nick Kennedy ◽  
Sisira Jayathissa ◽  
Paul Healy
Keyword(s):  
Pulmonary Embolism ◽  
Current Practice ◽  
Pulmonary Angiography ◽  
Pretest Probability ◽  
British Thoracic Society ◽  
Suspected Pulmonary Embolism ◽  
Ct Pulmonary Angiography ◽  
Wells Score ◽  
Positive Rate ◽  
D Dimer

Aims. To study the use of CT pulmonary angiography (CTPA) at Hutt Hospital and investigate the use of pretest probability scoring in the assessment of patients with suspected pulmonary embolism (PE).Methods. We studied patients with suspected PE that underwent CTPA between January and May 2012 and collected data on demographics, use of pretest probability scoring, and use of D Dimer and compared our practice with the British Thoracic Society (BTS) guideline.Results. 105 patients underwent CTPA and 15% of patients had PE. 13% of patients had a Wells score prior to their scan. Wells score calculated by researchers revealed 54%, 36%, and 8% patients had low, medium, and high risk pretest probabilities and 8%, 20%, and 50% of these patients had positive scans. D Dimer was performed in 58% of patients and no patients with a negative D Dimer had a PE.Conclusion. The CTPA positive rate was similar to other contemporary studies but lower than previous New Zealand studies and some international guidelines. Risk stratification of suspected PE using Wells score and D Dimer was underutilised. A number of scans could have been safely avoided by using accepted guidelines reducing resources use and improving patient safety.

scholarly journals Clinical profile of patients of acute pulmonary thromboembolism

2019 ◽  
Vol 6 (4) ◽  
pp. 1089
Author(s):  
Arundhati Diwan ◽  
Supriya Barsode ◽  
Chandrakant Chavan ◽  
Rohit Jakhotia ◽  
Krishnapriya Vadlapatla
Keyword(s):  
Pulmonary Embolism ◽  
Risk Factor ◽  
Mortality Rate ◽  
Tertiary Care ◽  
Pulmonary Angiography ◽  
Clinical Profile ◽  
Care Hospital ◽  
Male Predominance ◽  
Co Morbidity ◽  
History Of

Background: Pulmonary embolism is a common and potentially life threatening condition. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. The aim of the study was to observe the clinical profile, management and outcome in patients of pulmonary embolism.Methods: A prospective observational study was conducted in the Department of Medicine in a Tertiary care hospital in Western Maharashtra for a period of two years. 55 patients with confirmed diagnosis on CTPA (Computed tomography pulmonary angiography) were included in our study. A detailed history, examination and investigations like D dimer were done in all cases.Results: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%..Conclusions: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%.

D-Dimer Assay to Exclude Pulmonary Embolism in High-Risk Oncologic Population: Correlation with CT Pulmonary Angiography in an Urgent Care Setting

Radiology ◽  
2008 ◽  
Vol 247 (3) ◽  
pp. 854-861 ◽  
Author(s):  
Valencia King ◽  
Anjali A. Vaze ◽  
Chaya S. Moskowitz ◽  
Larry J. Smith ◽  
Michelle S. Ginsberg
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Care Setting ◽  
Pulmonary Angiography ◽  
Urgent Care ◽  
Ct Pulmonary Angiography ◽  
Population Correlation ◽  
Urgent Care Setting ◽  
D Dimer

scholarly journals High D-dimer is a predictor for short-term mortality in patients with active cancer and acute pulmonary embolism

2021 ◽  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Performance Status ◽  
Tertiary Care ◽  
Eastern Cooperative Oncology Group ◽  
Care Hospital ◽  
Ecog Performance Status ◽  
Acute Pe ◽  
D Dimer ◽  
Active Cancer

Objectives: Acute pulmonary embolism (PE) is the main cause of death in cancer patients, but there are limited prognostic tools for the patients with active cancer and acute PE. We aimed to identify prognostic factors of 30-day mortality in patients with active cancer and acute PE. Methods: This retrospective observational study included all adult patients aged ≥18 years with active cancer and acute PE from February 2017 to February 2019 at the emergency department in tertiary care hospital, Seoul, Korea. The primary outcome is 30-day mortality. Results: A total of 178 patients were included with a mean age of 63.9 years (SD 10.4) and males of 52.8%. The overall 30-day mortality rate was 30.9%. In a multivariable logistic analysis, high D-dimer, defined as ≥median value of 14.7 µg/mL, with odds ratio (OR) 2.47 (95% confidence interval [CI], 1.15–5.33), high Pulmonary Embolism Severity Index (PESI) scores with OR 2.95 (95% CI, 1.21–7.75) for class IV and OR 2.90 (95% CI, 1.06–7.90) for class V, and Eastern Cooperative Oncology Group (ECOG) performance status 3/4 with OR 3.22 (95% CI, 1.18–8.76) were independent predictors of 30-day mortality. Conclusion: High D-dimer values, high PESI scores, and poor ECOG performance status may be reliable predictors of mortality in patients with active cancer and acute PE.

scholarly journals CT Pulmonary Angiography in Young Women

2017 ◽  
Vol 24 (3) ◽  
pp. 423-428 ◽  
Author(s):  
Paul D. Stein ◽  
Fadi Matta ◽  
Kate E. Hughes ◽  
Mary J. Hughes
Keyword(s):  
Pulmonary Embolism ◽  
Pregnant Women ◽  
Chest Radiograph ◽  
Young Women ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Angiography ◽  
Ct Pulmonary Angiography ◽  
Computed Tomographic ◽  
Lung Scan ◽  
D Dimer

The purpose was to determine whether young women in the emergency department who received computed tomographic (CT) pulmonary angiograms were evaluated to receive lower dose imaging or no imaging, recognizing that the risks of radiation are particularly high in young women. This was a retrospective cohort investigation of women aged 18 to 29 years seen for suspected acute pulmonary embolism in emergency departments of 5 regional hospitals from May 1, 2015 to April 30, 2016. Computed tomographic (CT) pulmonary angiograms were obtained in 379 young women. Pulmonary embolism was diagnosed by CT angiography in 2.1%. A Wells probability score could be calculated in 11.9%. D-dimer was obtained in 46.2% and a chest radiograph was obtained in 41.7%. Among patients with a normal chest radiograph, 3.9% had a lung scan. Venous ultrasound of the lower extremities was obtained in 1.8%. Each had an elevated D-dimer. Among the young women who received CT angiograms, 53 were pregnant. In 17.0% of pregnant women, a Wells clinical probability score could be calculated from the medical record. D-dimer in pregnant women was obtained in 30.2%, chest radiograph in 22.6%, lung scan in 11.3%, and venous ultrasound of the lower extremities in none. In conclusion, young women and pregnant women often received CT pulmonary angiograms for suspected acute pulmonary embolism without an objective clinical assessment, measurement of D-dimer, lung scintiscan, or venous ultrasound, which may have eliminated the need for CT pulmonary angiography in many instances.

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