Exploring Pulmonary Embolism in Emergency Department Patients Presenting with Chest Pain: A Retrospective Multicenter Study

Santosh  Kumar; Vishwanath  Ankad; Santosh  Kumar

doi:10.51168/sjhrafrica.v5i6.1239

Authors

Santosh Kumar Senior Resident, Department of General Medicine, IGIMS, Patna, Bihar, India
Vishwanath Ankad Associate Professor & HOD, Department of Anaesthesia & Critical Care , ESIC Medical college and Hospital, Bihta , Patna, Bihar , India
Santosh Kumar Senior Resident, Department of Anaesthesia & Critical Care, ESIC Medical College and Hospital, Bihta Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i6.1239

Keywords:

Chest Pain, Pulmonary Embolism, Emergency Department, Diagnostic Protocols, Outcomes

Abstract

Background:

Emergency department (ED) visits due to chest pain are common, and they can be caused by a wide range of differential diagnoses, including potentially fatal illnesses like pulmonary embolism (PE). Recent advancements in diagnostic strategies have aimed to improve the accuracy and efficiency of identifying the underlying cause of chest pain, thereby optimizing patient management and outcomes. This study aimed to assess the diagnostic accuracy and clinical outcomes associated with current protocols for evaluating chest pain.

Methods:

A retrospective multicenter study was carried out over one year. A total of 200 patients presenting with chest pain were included, and data were collected regarding demographic characteristics, clinical presentations, diagnostic procedures (including D-dimer, CT pulmonary angiography), and outcomes.

Results:

The participants had a mean age of 56.3 years (± 12.7), with 60% males and 40% females. Common comorbidities included hypertension (47.5%) and diabetes (30%). Symptom duration averaged 12.5 hours (± 6.3). Past medical histories included coronary artery disease (15%) and prior DVT/PE (5%). Among the cohort, 25% of patients underwent diagnostic testing for PE, with 60% of these cases confirming the diagnosis. Factors such as age (>65 years), comorbidities (especially cardiovascular diseases), and specific chest pain characteristics (pleuritic and sharp quality) were significantly associated with a higher likelihood of initiating diagnostic workup for PE.

Conclusion:

The study underscores the complexity of diagnosing PE among people presenting with chest pain, emphasizing the utility of integrated clinical assessment and advanced imaging techniques. Improved adherence to standardized diagnostic algorithms and risk stratification tools could enhance diagnostic accuracy and optimize patient care outcomes.

Recommendations:

Based on the findings, it is recommended to integrate high-sensitivity biomarkers and structured risk assessment tools (e.g., HEART score, PERC rule) into routine ED practice to expedite diagnostic decision-making and improve resource utilization.