Pulmonary embolism: Epidemiological data and diagnosis in Kinshasa hospitals

BACKGROUND: Pulmonary embolism (PE) is common but difficult to diagnose. OBJECTIVE : To describe the epidemiological, clinical and paraclinical characteristics of PE in Kinshasa hospitals. METHOD: This was a retrospective study in 158 cases with suspected PE. RESULT S : The prevalence of PE was 37% among cases with suspicion of the disease. Male sex was predominant (55%). The mean age was 55 6 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. CONCLUS ION: PE is common in Kinshasa, with characteristics similar to those reported in the literature.