Pulmonary Embolism at the Luxembourg University Hospital in Bamako: A Cross-Sectional Study of 48 Cases

Introduction: The objective was to study the epidemiological, clinical, therapeutic and evolutionary aspects of pulmonary embolism at the Luxembourg University Hospital in Bamako. Patients and Methods: Cross-sectional study with prospective recruitment from January to December 2023 including all patients hospitalized in the cardiology department for PE. Results: We collected 48 cases of PE out of 580 hospitalized patients, i.e. a hospital frequency of 8.27%. The predominance was female, with a sex ratio of 0.92. The mean age of patients was 57.42 ± 14.66 years. The 46 - 65 age group was the most affected, at 47.91%. Risk factors for VTE were dominated by sedentary lifestyle (54.16%), hypertension (39.58%), obesity (37.50%), diabetes (22.91%), and history of heart disease (8.33%). The main symptoms were: dyspnea (91.70%), chest pain (70.80%) and cough (25%). The ECG noted: tachycardia (68.75%), S1Q3T3 (18.75%) and right block (6.25%). The simplified PESI score was ≥ 1 in 50% of our patients. Transthoracic cardiac Doppler ultrasound showed right cavitary dilation (64.58%), PAH (52.08%) and right intraventricular thrombus (6.25%). Chest CT angiography was normal at 6.30% and an embolus at 93.70%. DVT was found on venous Doppler of the lower extremities in 41.66% of patients. Treatment consisted of curative dose LMWH with VKA (56.25%) or DOAC (43.75%) relay for a duration of 6 months. Thrombolysis was used in 33.33% of patients with PE at high risk of early mortality. The evolution was favorable at 95.84% and the case fatality rate was 4.16%. Conclusion: Pulmonary embolism is relatively common but underdiagnosed with a female predominance. Chest pain and dyspnea are the classic functional signs.