P7 Are we screening survivors of pulmonary embolism (PE) for chronic thromboembolic pulmonary hypertension (CTEPH)?

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Abstract

Background

Incidence of CTEPH following idiopathic PE has been reported as 4%. The British Thoracic Society recommends that patients with massive or submassive PE should undergo echocardiography 6–12 weeks following the index event.

Aim

To investigate local practice in the follow-up of patients with acute PE to devise management guidelines.

Methods

A retrospective study of 110 patients diagnosed with acute PE at our hospital between 2007 and 2008 was conducted. Mean age was 68.6 years (range 27–100), 40 (36%) were male and 18 (16%) had previous venous thromboembolism. In 51 (46%) patients PE was idiopathic.

Results

All patients diagnosed with PE were normotensive and 27 (25%) had in-patient echocardiography (ECHO). In 5 (18%) patients scan confirmed RV dilatation and 2 of them had repeated ECHO within 2 months. Subsequently one patient was diagnosed with CTEPH and underwent pulmonary endarterectomy. In the group of patients with acute PE but without in-patient echocardiography 40 of 83 (48%) received a follow-up appointment (mean 4 months) and 10 (25%) had follow-up ECHO. Two more patients were diagnosed with CTEPH during this period (mean 34 months) with an overall incidence of 2.9%.

Conclusion

Recorded outcome, literature review and the BTS/ERS guidelines resulted in the development of local protocol for the screening acute PE survivors for CTEPH. [Abstract P7 figure 1].

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