RELATIONSHIP BETWEEN AIR POLLUTION AND PULMONARY EMBOLISM AS ASSESSED BY CT PULMONARY ANGIOGRAPHY

Abstract

SUMMARY C ardiovascular diseases have caused significant human and public health burden, air pollution is associated with increased risk of arterial cardiovascular diseases possibly resulting from enhance coagulation and arterial thrombosis. It is now evident that MDCT pulmonary angiography provides reliable confirmation of the presence of pulmonary emboli down to the segmental and sub-segmental levels. Embolic filling defects at different segments of the pulmonary arteries could be easily seen, as well as, other CT signs of PE. It can be considered as the first line investigation for imaging patients with suspected acute PE. In this study we examined the possible relationship between air pollution especially PM and Pulmonary Embolism (PE). Eighty four PE suspected patients were enrolled in this study, after classification of them according to the clinical probability and D-dimer test results only sixty seven patients underwent CTPA, 50 patients were positive, 13 were negative and four cases were sent to perform V/Q Scan (three of them were positive and one case is negative). AQI of the area of residence of all positive PE cases (by CTPA) was determined and classification of patient according to AQI into three main groups: group with unhealthy for sensitive groups AQI, group of unhealthy AQI, group of very unhealthy AQI. In this study we found that there is high significant relationship between air pollution and PE especially in patients with one or more thromboembolic risk factors and also we explored the very important role of CTPA in diagnosis of PE down to the segmental and sub-segmental levels of both lung fields as Multi Detector CTPA can be considered the gold stander for diagnosis of PE.