Faryal Riaz, Amna Malik.
Audit on the Use of CTPA in patients with Clinically Suspected Pulmonary Embolism.
J Cardiovascular Dis Jan ;17(3):153-7.

BACKGROUND: Acute pulmonary embolism (PE) is a usual and frequently lethal sequelae of venous thromboembolic disease (VTE) (1). PE is a considerable healthcare load that is mortality of more than 15% in few months after identification of PE(2) .The subjective manifestations of acute PE is fluctuating. Majority may be asymptomatic, or unexpected demise may be the first manifestation. Usual clinical symptoms of acute PE comprises angina, rapid heartbeat, low blood pressure, shortness of breath, cough and spitting up blood. AIMS & OBJECTIVE: To evaluate PE diagnostic examination before sending request for CTPA and to investigate if CTPA is exceedingly demanded. MATERIAL & METHODS: This study was conducted in the department of diagnostic radiology in collaboration with department of cardiology, PIC, Lahore over a period of 9 months from 01-03-2020 to 30-11-2020. All patients who had clinical suspicion of pulmonary embolism and age (20-60 years) were included in the study and exclusion criteria was CKD, contrast allergy and patients with chronic lung disease. the results of patients demographics, pre CT work up (Well`s score, Chest X-Ray, ECG, D-Dimers, Doppler USG for DVT and CTPA findings) were calculated, entered in SPSS version 21 and simple % was estimated. This data was correlated with other similar researches. RESULTS: in our research 75 patients were followed up for pulmonary embolism, 39 (52%) were males and 36 (48%) were females. Mean age was 44 years, 5 (7%) had malignancy, 12 (16%) had previous surgery or trauma, 30 (40%) had previous DVT. Wells score was calculated in (7%), ECG (15%), CXR (70%), D-Dimer (7%). Only (35%) patients were having pulmonary embolism on CTPA. Wells score was calculated before CTPA in only (4%) of patients diagnosed PE on CTPA. CONCLUSION: the study proposes that CTPA was an exceedingly demanded investigation in our hospital and insufficient prior clinical assessment is leading to improper use of CTPA.

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