Patients with pulmonary embolism (PE) who present to the emergency department with syncope are more likely to have a high-risk, large embolism, with a chief complaint of syncope significantly more common in those with recent airline travel, according to a study presented at the annual meeting of the American College of Chest Physicians, held from Oct. 20 to 25 in Atlanta.
To examine whether there were common findings among patients with PE who present to the emergency department with syncope, Robert P. Rifenburg, MD, and Jeffrey Kovlar, MD, of Resurrection Medical Center in Chicago, conducted a five-year, retrospective medical record review of 674 cases of PE, of which 126 were excluded because they were not diagnosed by computed tomography or were missing medical records.
The researchers found that, of the 548 PE cases, the average patient age was 68.9 years, and 41.6 percent were men. In this group, 10 percent of patients presented to the emergency department with syncope as their main complaint. For patients with PE, syncope was a significantly more common chief complaint after recent airline travel (48 versus 8.1 percent). Compared with those who did not present with syncope, the syncope group exhibited significantly more nonspecific ST-T wave changes, sinus tachycardia, S1Q3T3 abnormality, saddle emboli, and ventricular hypertrophy diagnosed on echocardiography.
"Fainting may be an atypical symptom of PE, but fainting associated with recent air travel is a dangerous combination," Rifenburg said in a statement.
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