Clinical Symptoms and Echocardiographic Markers Regarding the Severity of Embolism in Patients with Acute Pulmonary Embolism.

Background: Echocardiography can be used for risk stratification in patients with acute pulmonary embolism (PE). While the severity of PE has been assessed through laboratory criteria in most studies, the Pulmonary Embolism Severity Index (PESI) scoring system was used in this study to evaluate the severity of echocardiographic criteria in acute PE patients.

Materials and methods: All PE patients admitted to Ghaem Hospital in Mashhad between 2021-2022 were included in the study. Clinical symptoms and echocardiographic markers were checked and recorded when the patients entered the study. Data were analyzed in SPSS version 24 at a significance level of 0.05 using the Chi-square test and t-test.

Results: Of 40 patients, 80% were at a high risk of PESI. The most common clinical symptoms were dyspnea (97.5%) and pleuritic chest pain (75%). Right ventricle (RV) size enlargement and its dysfunction were recorded in 57.5% of patients. The average age of patients in the high-risk group was significantly (pvalue: 0.001) higher than the low-risk group. There was a significant correlation between MID-right ventricle and pulmonary artery pressure with the severity of embolism, so that mid-right ventricle and pulmonary artery pressure in the high-risk group were significantly higher (p-value: 0.000) than in the low-risk group. Also, the severity of PE was significantly related to RV size (P = 0.026) and function (P = 0.038).

Conclusion: RV size, function, and dilatation, and pulmonary artery pressure variated significantly in different severities of PE.