Pulmonary embolism: epidemiological data and diagnosis in Kinshasa hospitals

• DOI: 10.5588/ijtld.16.0418
• Publication Date: 2017-08-08T14:50:27Z
• Authors: A. Bakebe; I. Kashongwe; C. Mulenga; M. Tshiasuma; B. Kabengele; S. F. Bisuta; J. R. Makulo; Z. Kashongwe; J-M. Kayembe
• Keywords: Adult; Male; Chest Pain; Computed Tomography Angiography; Anticoagulants; Middle Aged; Prognosis; Severity of Illness Index; 3. Good health; Fibrin Fibrinogen Degradation Products; 03 medical and health sciences; Dyspnea; 0302 clinical medicine; Cough; Echocardiography; Risk Factors; Democratic Republic of the Congo; Prevalence; Humans; Female; Pulmonary Embolism; Aged; Retrospective Studies

Pulmonary embolism (PE) is common but difficult to diagnose.To describe the epidemiological, clinical and paraclinical characteristics of PE in Kinshasa hospitals.This was a retrospective study in 158 cases with suspected PE.The prevalence of PE was 37% among cases with suspicion of the disease. Male sex was predominant (55%). The mean age was 55 ± 15 years. The main risk factors were obesity (53%), immobilisation (43%) and surgery (14%). The main symptoms were dyspnoea (98%), cough (59%), chest pain (43%) and unilateral limb pain (36%). Tachypnoea (88%), tachycardia (53%) and signs of deep-vein thrombosis (36%) were the main clinical presentations. Lung examination was normal in 55% of the patients. PE prevalence in the 'PE likely' category based on the Wells score was 53%. Levels of D-dimers were elevated in all patients. Sinus tachycardia (72%), S1Q3T3 pattern (30%) and T-wave inversion in V1-V4 (34%) were the main electrocardiographic abnormalities. Chest X-ray was normal in 30% of patients. Right ventricular pressure overload was detected in 58% of patients who had access to echocardiography. Computed tomography pulmonary angiography was performed in 65% of patients. All patients were treated with anticoagulants; no cases received thrombolytics. Patients who died (7%) were all in class III-V according to the Pulmonary Embolism Severity Index prognostic score.PE is common in Kinshasa, with characteristics similar to those reported in the literature.