Pulmonary embolism: a frequent occurrence in Indian patients with symptomatic lower limb venous thrombosis.

OBJECTIVE: Pulmonary embolism (PE) is the most severe complication of deep venous thrombosis (DVT). There have been very few studies to assess the prevalence of PE in Asian patients. The objective of this study was to define the prevalence of PE in patients presenting with suspected lower limb DVT. METHODS: This was a prospective cohort study at Sir Ganga Ram Hospital, a large multispecialty hospital in New Delhi, India. From January 2001 to July 2004, 1,552 consecutive inpatients and outpatients who presented with clinically suspected lower limb DVT were enrolled in the study. Combined ascending radionuclide venography and lung perfusion scan was performed in all patients. Patients with evidence of pulmonary perfusion defects underwent ventilation lung scan. RESULTS: Radionuclide venography-detectable DVT was noted in 744 patients, of whom 521 (70%) had suprapopliteal DVT. Of patients with DVT, 294 (39.5%) showed a high-probability lung scan and 135 (18.1%) had an intermediate-probability lung scan. Overall, 47% of patients with a high-probability scan had no clinical manifestations suggestive of PE. CONCLUSION: PE occurs frequently in Indian patients with symptomatic DVT. Increasing awareness will provide us with clearer ideas about the prevalence of venous thromboembolism in Asian countries.

Ruptured chronic traumatic mycotic pseudoaneurysm of the ascending aorta.

We report a rare case of posttraumatic chronic mycotic pseudoaneurysm of the ascending aorta presenting with acute rupture. The uniqueness of the case lies in its unusual etiology, presentation, and management with direct repair of the aorta without using cardiopulmonary bypass.