Abstract:
BACKGROUND:the incidence of pulmonary embolism increases with age but the 'classical' presentation of acute pulmonary embolism may not occur in older persons. OBJECTIVES:to compare the clinical presentation of younger and older patients with acute pulmonary embolism. DESIGN:retrospective identification of 60 consecutive cases of spiral computed tomography confirmed acute pulmonary embolism over a 3-year period, with blinded review of radiological films and electrocardiographs, and analysis of clinical presentation. SETTING:a district general hospital serving a population of 200,000 people. SUBJECTS:31 younger and 29 older patients with acute pulmonary embolism. RESULTS:older persons less often complained of pleuritic chest pain (P < 0.02), particularly as their primary presenting complaint (P < 0.002). Twenty-four percent of older but just 3% of younger persons presented with collapse (P < 0.02), despite similar proportions of central and peripheral emboli in the two groups. Older persons were more often cyanosed (P = 0.05) and hypoxic (P < 0.04) than younger persons but there were no significant differences with respect to heart rate, respiratory rate or mean arterial blood pressure. CONCLUSIONS:older people present atypically with acute pulmonary embolism, potentially leading to delays in diagnosis and initiation of treatment. Collapse is a particularly important symptom of acute pulmonary embolism in older persons, even in the absence of pain.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Timmons S,Kingston M,Hussain M,Kelly H,Liston Rdoi
10.1093/ageing/afg098subject
Has Abstractpub_date
2003-11-01 00:00:00pages
601-5issue
6eissn
0002-0729issn
1468-2834journal_volume
32pub_type
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