Initial symptoms in pulmonary embolism differ from those in pneumonia: a retrospective study during seven years
| Autor: | Mårten Söderberg, Malgorzata Sjunnesson, Ulla Hedström, Christina Jorup-Rönström, Gerd Lärfars |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Diagnosis Differential medicine Humans Diagnostic Errors Aged Retrospective Studies Aged 80 and over Sweden Retrospective review business.industry Retrospective cohort study Pneumonia Middle Aged medicine.disease humanities Pulmonary embolism Emergency Medicine Female Pulmonary infiltrates Radiology Differential diagnosis Emergency Service Hospital Pulmonary Embolism business |
| Zdroj: | European Journal of Emergency Medicine. 13:225-229 |
| ISSN: | 0969-9546 |
| DOI: | 10.1097/01.mej.0000217980.69459.80 |
| Popis: | To compare initial symptoms in pulmonary embolism with community-acquired pneumonia and relate to C-reactive protein and pulmonary infiltrates in order to improve the clinical assessment at the emergency department.A retrospective review of patients with pulmonary embolism diagnosed in the clinic for infectious diseases (CID), (n=25), and a randomized sample of patients with pulmonary embolism diagnosed in the department of medicine (n=64), and a randomized sample of patients with community-acquired pneumonia (n=54) diagnosed in the clinic for infectious diseases.Initial symptoms in pulmonary embolism, dominated by dyspnoea and/or pleuritic chest pain were significantly different from those in community-acquired pneumonia, dominated by fever, chills and/or cough (P0.001). On admission, C-reactive protein and body temperature were significantly higher and pulmonary infiltrates were more common in pneumonia compared with randomized pulmonary embolism patients. Twenty-five patients with a final diagnosis of pulmonary embolism were erroneously suspected of having lung infection, owing to increased C-reactive protein, presence of pulmonary infiltrates and/or high fever. However, they had classical symptoms of pulmonary embolism.Pulmonary infiltrates, high fever and a high level of C-reactive protein can deceive the physician to suspect pneumonia instead of pulmonary embolism. Classical initial symptoms ought to direct the physician in diagnosing pulmonary embolism. We emphasize a detailed patient history of initial symptoms. |
| Databáze: | OpenAIRE |
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