[The clinical features of 516 patients with acute pulmonary thromboembolism].

OBJECTIVE

To evaluate the clinical signs and symptoms of acute pulmonary thromboembolism (PTE) and the improvement after thrombolytic and anticoagulant therapy.

METHODS

516 patients with a first episode of PTE were included in the multicenter randomized study with prospective data collection: 246 with massive and sub-massive PTE and 270 with non-massive PTE. Thrombolytic agents (urokinase or rt-PA randomized) were used for massive and sub-massive PTE and anticoagulant agents (IV infusion of unfractioned heparin or subcutaneous of low-molecular-weight heparin randomized) were administered for non-massive PTE. All patients were submitted to symptoms (such as dyspnea, chest pain, cough, haemoptysis, syncope, etc) and signs (including lung and heart signs) surveillance before treatment and 14 days after treatment were calculated. The percentages of clinical features on the day of before treatment, and 1, 4, 7, 10 and 14 days after treatment.

RESULTS

Dyspnea (88.6%), chest pain (59.9%, include angina pain and pleuritic pain) and cough (56.2%) were the most frequent initial symptoms. Hemoptysis presented in only 26.0% of all patients. Increase of respiratory rate was the most frequent signs (51.7%). Syncope and low body pressure (or shock) were seen in 22.8 % and 21.5% of the patients with massive and sub-massive PTE respectively. Cyanosis (45.9%) and increased S(2)P (63.0%) were the most common signs in this group. All symptoms and signs cleared progressively from the pre-treatment evaluation to the 14 day follow-up examination.

CONCLUSION

Dyspnea is the most common symptom of acute PTE, and is aggravated with the degree of PTE. Tachypnea is the most common sign. Thrombolytic and anticoagulant therapy can improve the clinical features of acute PTE markedly.