Pulmonary embolism as a cause of death in adults who died with heart failure.

Although heart failure (HF) is a known risk factor for pulmonary embolism (PE), little is known about the frequency of death from PE in patients who die with HF. This investigation was undertaken to determine the frequency of PE as the cause of death in patients who died with HF on the basis of data from death certificates, as listed by the United States Census Bureau. Among adults with HF who died over the 19-year period of study, PE was the listed cause of death in 20,387 of 755,807 (2.7%). Assuming that the accuracy of death certificates was only 26.7%, the rate of death from PE in these patients may have been as high as 10.1%. The frequency of death from PE in patients who died with HF decreased from 1980 to 1998. In conclusion, the estimated death rate from PE in patients who died with HF is 3% to 10%. A decrease over 2 decades in the proportion of deaths from PE in such patients is compatible with the increasing and effective use of antithrombotic prophylaxis.