Analysis of Misdiagnosis of Acute Pulmonary Thromboembolism in Patients Aged over 88 Years and Literature Review
YANG Dongcai
REN Huimin
CHENG Jiaxin
LU Chenyang
BU Lina
LIU Zhiyan
Li Nan
JIA Weihong
Abstract：Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures of acute pulmonary thromboembolism(APTE)in patients aged over 88 years.Methods The clinical data of 4 patients aged over 88 years who had APTE and was admitted from January 2020 to May 2023 were retrospectively analyzed.Results There were 4 cases of coronary heart disease(CHD),3 cases of hypertension,2 cases of diabetes,2 cases of atrial fibrillation,and 1 case of chronic obstructive pulmonary disease(COPD).Chest tightness,shortness of breath,cough and expectoration oc-curred in 4 cases,respectively,chest pain in 1 case,syncope in 1 case and fever in 1 case.There was 1 cases of mild hypox-emia,3 cases of moderate hypoxemia and 3 cases of type I respiratory failure.ECG examination of atrial fibrillation,ST-T changes and T wave inversion in 2 cases,respectively,and 1 case of first degree atrioventricular block(AVB).CT angiogra-phy(CTA)of pulmonary artery indicated multiple pulmonary embolism.It was misdiagnosed as pneumonia in 2 cases,CHD in 1 case and respiratory failure in 1 case.Misdiagnosis lasted from 2 to 15 d.After confirmation by pulmonary CTA,all pa-tients were treated with anticoagulant therapy for 7-10 d and discharged from hospital.At 3 months after discharge,3 cases were cured and 1 case was under follow-up.Conclusion The main causes of misdiagnosis of APTE patients aged over 88 years were many underlying diseases and poor cardiopulmonary function,which masked the clinical symptoms caused by acute pulmonary embolism.In clinical practice,patients aged over 88 years with surgery,trauma,malignant tumors and chronic diseases of the heart,lung and brain should be routinely screened for deep vein embolism,and pulmonary embolism screening should be performed if necessary.
Keywords：Pulmonary embolismAged88 and overMisdiagnosisPneumoniaCoronary heart diseaseRespira-tory insufficiencyAngiographyTomographyspiral computed
Publication Date：2023-08-22
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 1-7 )