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Original Research: PULMONARY EMBOLISM |

Pulmonary Embolism as a Cause of Death in Patients With Heart Disease*: An Autopsy Study

Tomás Pulido, MD; Alberto Aranda, MD; Marco Antonio Zevallos, MD; Edgar Bautista, MD, FCCP; Maria Luisa Martínez-Guerra, MD; Luis Efrén Santos, MD, MSc, FCCP; Julio Sandoval, MD
Author and Funding Information

*From the Cardiopulmonary (Drs. Pulido, Zevallos, Bautista, Martínez-Guerra, Santos, and Sandoval) and Pathology (Dr. Aranda) Departments, Instituto Nacional de Cardiología “Ignacio Chávez,” Mexico City, Mexico.

Correspondence to: Julio Sandoval, MD, Departamento de Cardioneumología, Instituto Nacional de Cardiología “Ignacio Chávez,” Juan Badiano #1, Col. Sección XVI, México D. F., Tlalpan 14080, México D.F., México; e-mail: julio.sandoval@cardiologia.org.mx



Chest. 2006;129(5):1282-1287. doi:10.1378/chest.129.5.1282
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Study objective: To establish the prevalence of pulmonary embolism (PE) in autopsy material at a tertiary cardiac referral center and its importance as a cause of death in patients with heart disease (HD).

Design: Case series.

Setting: National Heart Institute, Mexico City.

Patients: One thousand thirty-two patients who died at our institution from 1985 to 1994 in whom an autopsy study was performed.

Measurements and results: Of the 1,032 autopsies reviewed, 231 cases (24.4%) of PE were found; 100 of these patients had a diagnosis of massive PE. Massive PE (obstruction of either of the main pulmonary arteries or more than two lobar arteries) was found to be the third cause of death in this HD population. By age-group distribution, the global prevalence of massive events was higher in patients < 10 years old. Clinical suspicion (premortem) was raised in only 18% of the cases.

Conclusions: PE was a frequent cause of morbidity and mortality in patients with HD who underwent autopsies. The incidence of massive PE was high in children.

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