Chest radiographs in acute pulmonary embolism

ABSTRACT

Pulmonary embolism [PE] is a serious clinical entity carrying significant morbidity and mortality. Clinically, it is a difficult condition to diagnose and remains under treated condition in Pakistan due to non-availability of objective tests and lack of awareness among physicians. This study was conducted to determine the chest radiographic presentation in known cases of acute PE presenting to a tertiary care hospital. hospital records of patients with a diagnosis of acute PE were reviewed from June 2000 until June 2004. fifty diagnosed cases of defect were selected. Two chest physicians reviewed the chest demonstrating an intraluminal-filling hospitalization. In case of discrepancy, a radiologist made final interpretation. The chest radiograph was interpreted as normal in only 18% of patients with acute PE. The most common chest radiographic abnormalities were cardiac enlargement [38%], pulmonary parenchymal infiltrates [34%], atelectasis [26%], pleural effusion [24%], and pulmonary congestion [24%]. Other rare findings were elevated hemi diaphragm [14%], pulmonary artery enlargement [14%], and focal oligemia [8%]. Cardiomegaly is the most common chest radiographic abnormality associated with acute pulmonary embolism. Its major role is in identification of alternative disease processes that can mimic thrombo-embolism