Venous thromboembolism (VTE) includes pulmonary embolism (PE) and deep vein thrombosis (DVT). PE is third most common cause of cardiovascular death worldwide after stroke and heart attack. Management of PE has evolved recently with availability of local thrombolysis; mechanical extraction devices; hemodynamic support devices like extracorporeal membrane oxygenation; and surgical embolectomy.

The aim of our work is to study the clinical features and the management of pulmonary embolism in a cardiology department.

We performed a prospective study of 120 patients hospitalized between 2016 and 2018 for acute pulmonary embolism in the cardiology department of CHU Casablanca.

A total of 120 patients (mean age 54.3±16.7 years, 77.5% women) with a confirmed PE were included in this study. For risk factors for thromboembolic disease, historic of cancer was present in 23.3%, immobility in 25%, oral contraception in 14%, obesity in 10.8%. Right ventricular dysfunction was assessed by echocardiography in 41.6%, with 48.3% with pulmonary hypertension. The most common clinical signs were dyspnea and chest pain. The most common physical signs were tachypnea and tachycardia. Electrocardiographic abnormalities were found in 35.8%. Chest X-ray was abnormal in 40%. D-dimer was high in 60 patients (50%). US doppler of deep leg veins was positive in 58.3% of patients. Pulmonary helical CT was positive in majority of cases. Unfractionated heparin was administered to about 45.8% of patients and low-molecular-weight-heparin was prescribed at only 22.5% of patients.

Management of pulmonary embolism in our cardiology department is characterized by the frequent use of non-invasive techniques on the diagnostic view and appeal to heparin on the therapeutic view.