Chest
Clinical InvestigationsLongterm Follow-up of Patients with Pulmonary Thromboembolism: Late Prognosis and Evolution of Hemodynamic and Respiratory Data
Section snippets
Patients and Methods
The present series is a review of all patients with TED who met the following criteria: (1) a diagnosis of TED confirmed by lung angiography and/or scintigraphy; (2) the absence of any other heart or lung disease (excluded on the basis of history, clinical examination, ECG, chest x-ray film findings, lung function tests, and cardiac catheterization); (3) hemodynamic investigation performed at least two months after the last clinically manifest episode of PE.
These criteria were met by 76
Clinical and Hemodynamic Data
Acute PE. Two patients had borderline PPA (21 and 22 mm Hg) and 12 had normal resting PPA (<20 mm Hg) on the first examination.
Two patients died seven years after the first examination-one of rupture of an aortic aneurysm, the other of an acute PE complicating biventricular heart failure. This patient suffered two myocardial infarctions and at least two recurrent PEs after the first examination. The remaining 12 patients were re-examined on an average 4.2 years after the first examination (Fig 1
Discussion
Pulmonary thromboembolic disease has a wide variety of clinical presentations. The definition of subgroups facilitates the understanding of the clinical pattern, the hemodynamic disturbance, the effect of treatment and the long-term prognosis in these patients.7 We have therefore defined four groups in terms of their clinical presentations. As longterm prognosis after PE is influenced by concomitant cardiorespiratory disease,3,5 patients with other heart or lung disease at the time of the first
Acknowledgments
The authors thank Drs. D. Dantzker, R. Hall, and E. Weitzenblum for their suggestions and critical reading of this manuscript.
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