Aims and objectives
Venous thromboembolism is a significant cause of morbidity and mortality globally and has a multifactorial aetiology,
that usually involves two or more risk factors.
Obesity is also a significant global health issue and a known risk factor for VTE .
Many signs and symptoms of pulmonary embolus such as tachycardia,
shortness of breath and hypoxaemia can be found at baseline in obese patients.
Morbidly obese patients demonstrate ECG changes such as low voltage,
T wave flattening and axis changes,
and even D dimers can elevated...
Methods and materials
A list was obtained of all the CTPAs performed in our institution between the ages 18-50 over a one year period.
As this was a retrospective study and BMI data was not possible,
a well-recognised surrogate for BMI was used called the “Fat/Bone ratio”,
which was obtained from the chest radiograph .
This involved measuring the soft tissue thickness over the acromio-clavicular joint and dividing it by the clavicular diameter at the midpoint of the clavicle.
A result of 0.5 corresponded to a BMI of...
230 CTPAs were performed in our institution over a one year period in patients age 18-50,
of which 221 were included.
129 were male and 92 were female.
69 (31%) patients were classified as obese by the fat/bone ratio criteria,
53 of which were female.
The average age of the obese category was 41.
11 studies (16%) were positive for pulmonary embolus.
58 studies (84%) were negative for pulmonary embolus.
Of the 11 positive studies,
8 (72%) were provoked and 3 (28%) were...
CT pulmonary angiography is the most sensitive test for diagnosis of pulmonary embolism and accounts for a significant proportion of the workload for any tertiary referral centre.
Studies have shown that the diagnostic accuracy of CTPA in patients weighing 75-99kg or 100-150kg is not significantly different .
As the Irish population’s problem with obesity continues to rise,
more requests for CTPAs will be placed due to the nonspecific signs and symptoms often present at baseline in the obese patient.
Our audit has demonstrated that there...
Mary-Louise Gargan MB BCh BAO MRCPI
Tallaght University Hospital,
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