Toda R, Vidal F, Benet A, Blavia R, García V, Richart C
Servicio de Medicina Interna, Hosptial de Tarragona Joan XXIII, Universidad de Barcelona.
Med Clin (Barc). 1992 Apr 18;98(15):561-4.
To evaluate the prevalence of syncope as a form of presentation of pulmonary thromboembolism (PTE) in the emergency department of a general hospital.
All the cases of PTE having gone to the emergency department between May 1983 and July 1989 were collected. A radiography of the thorax, arterial gasometry, an electrocardiogram and a pulmonary perfusion scintigraphy were performed in each patient. Ventilation scintigraphy and/or pulmonary DIVAS were also carried out when necessary.
Of a total of 63 patients, 15 (24%) had a syncope as a primary manifestation. No significant differences were observed in regards to predisposing factors between the syncope group (S) and the non-syncope group (NS) with there being a predominance of women in the S group (p less than 0.05). Furthermore, the S group had a greater prevalence of tachycardia, hypotension, electrocardiographic changes, pleural effusion and perfusion defect greater than 50% in the pulmonary scintigraphy.
PTE should be discarded in any patient with a clinical picture of syncope with hypotension and tachycardia, especially if female. When PTE is presented as a syncope it is generally a massive embolism.
评估在一家综合医院急诊科，晕厥作为肺血栓栓塞症（PTE）一种表现形式的发生率。
收集1983年5月至1989年7月间前往急诊科就诊的所有PTE病例。对每位患者进行胸部X线检查、动脉血气分析、心电图检查和肺灌注闪烁扫描。必要时还进行通气闪烁扫描和/或肺数字血管造影。
在总共63例患者中，15例（24%）以晕厥为主要表现。晕厥组（S）和非晕厥组（NS）在易感因素方面未观察到显著差异，S组女性居多（p<0.05）。此外，S组心动过速、低血压、心电图改变、胸腔积液以及肺闪烁扫描中灌注缺损大于50%的发生率更高。
对于任何有低血压和心动过速晕厥临床表现的患者，尤其是女性，应排除PTE。当PTE表现为晕厥时，通常为大面积栓塞。
