Table I.
Patients’ demographic features, clinical history and the time since hospital admission to thrombolysis.
| Patient |
Age (yrs) /sex |
BMI | Ethnicity |
Smoking |
Medical history | CTPA findings prior to thrombolysis | ECHO findings pre thrombolysis | Dose of alteplase | Days from admission to thrombolysis |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 66/F | 32·2 | Black(B/A) | No | Type 2 DM, HT | B/L multiple PE | RV systolic function impaired pressure overload of RV. Possible large RA thrombus | 10 mg bolus + 90 mg over 2 h | 9 |
| 2 | 53/F | 31·1 | Asian | No | Fatty liver | Right‐sided PE, no evidence of right heart strain |
Mildly dilated RV with good systolic function. No gross right heart strain |
10 mg bolus + 90 mg over 2 h |
8 |
| 3 | 75F | 32·6 | Asian | No | HT | B/L segmental PE |
Dilated RV and right heart strain |
50 mg over 90 mins | 9 |
| 4 | 60/M | 29·2 | Asian | No | Type 2DM, HI, IHD | B/L multiple small PE |
Right heart strain with raised RV pressures — TR max PG 17 mm Hg TAPSE 19 |
10 mg bolus + 90 mg over 2 h | 9 |
| 5 | 67/M | 18·8 | White | Yes | IHD | Massive B/L & evidence of right‐sided heart strain |
Mildly dilated left ventricle by volume. LV systolic function severely impaired (LVEF ~ 20%) Large LV echogenic structure measuring 8·33 cm × 5·6 cm consistent with thrombus Dilated RV with moderately impaired systolic function. Mild AR and MR. Mild to moderate TR. Estimated PASp = 49 mm Hg |
10 mg bolus + 90 mg over 2 h | 2 |
| 6 | 52/M | 34·0 | Asian | No | Type 2 DM, HT, hypercholesterolaemia | 'Presumed PE' no scan |
Dilated RV severely impaired systolic function with volume and pressure overload. Estimated PASP of 50 mm Hg |
10 mg bolus + 90 mg over 2 h | 19 |
| 7 | 69/F | 36·0 | Asian | No | Not significant | PE within the distal right main pulmonary artery extending to the right upper and middle lobe pulmonary arteries. There is some straightening of the interventricular septum and the RV:LV is high at 1·2 |
Mild LVH, good LV function RV mildly dilated: Mild TR |
50 mg over 90 min | 8 |
| 8 | 63/F | 31·0 | Black(B/A) | No |
Impaired glucose tolerance Asthma; bronchiectasis; pulmonary HTN |
Enlarged main pulmonary artery peripheral embolus in upper lobe on the left increased ground glass opacification more dense consolidation in dependent areas |
Dilated RV with evidence of RV strain Moderate TR. Estimated PASP 64–69 mm Hg. Dilated IVC size (2.2 cm) |
50 mg over 90 min | 24 |
| 9 | 59/M | 39·1 | Black(B/A) | Not recorded | Eczema; obesity | Left lower lobe segmental PE. Smaller subsegmental Pes obscured by the grossly abnormal lungs. Evidence of right heart strain | Dilated RV and right heart strain | 50 mg over 90 min | 21 |
| 10 | 57/M | 35·4 | Black(B/A) | Not recorded | Type 2 DM, HT, hypercholesterolaemia | Presumed PE based on ECHO | RV massively dilated, moderate‐severe RV pressure and volume overload, signs of LV intracavitary compromise. Unbalanced circulation. presumed PE |
50 mg over 90 min |
13 |
| 11 | 64/M | 32·2 | Black(B/A) | No | Type 2 DM, | Bilateral, multiple pulmonary embolism | Dilated RV and right heart strain | 50 mg over 90 min | 9 |
| 12 | 51/M | 31·1 | Asian | No | Not significant | Left‐sided PE, no evidence of right heart strain | Volume and some pressure overload of RV and Possible large RA thrombus | 10 mg bolus + 90 mg over 2 h | 11 |
B/A, British or African; M, Male; F, Female; BMI, body mass index (weight/height2); DM, diabetes mellitus; HT, hypertension; IHD, ischaemic heart disease; B/L, bilateral; PE, pulmonary embolism; LV, left ventricle; RV, right ventricle; RWMA, reginal wall motion abnormality, TAPSE, tricuspid annular plane systolic excursion; RA, right atrial; TR, tricuspid regurgitation; PG, pressure gradient; AR, aortic regurgitation; MR, mitral regurgitation; PASp, pulmonary artery systolic pressure; LVH, left ventricular hypertrophy.