Significance of acute pulmonary embolism for the exacerbation of chronic obstructive pulmonary disease

The clinical diagnosis of acute pulmonary embolism in patients with chronic obstructive pulmonary disease is often difficult because there is no characteristics sign of acute pulmonary embolic event. The presentation of an acute embolic event may mimic the symptoms of acute airway obstruction which is caused by different reasons. The presence of chronic obstructive pulmonary disease was recorded on a clinical history, physical examination, chest roentgenogram, and the result of pulmonary function studies. Among the 178 patients with chronic obstructive pulmonary disease in 49 patients (27.5 percent) were suspected of having pulmonary embolism. Pulmonary embolism was excluded by normal or low probability V/Q scan in 19 patients. Among 23 patients who demonstrated a high probability lung scan there was a high positive predictive value for pulmonary embolism effectively avoiding the need for further studies. Among the 7 patients with nondiagnostic or intermediate probability lung scan contrast-enhanced helical computed tomography was detected the pulmonary embolism in 3 patients. The present study was undertaken to better define the noninvasive clinical, laboratory, roentgenographic, lung scan, and computed tomography characteristics of acute pulmonary embolism in patients with chronic obstructive pulmonary disease.