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lüll Pulmonary embolism: differences in presentation between older and younger patients Timmons S; Kingston M; Hussain M; Kelly H; Liston RAge Ageing 2003[Nov]; 32 (6): 601-5BACKGROUND: the incidence of pulmonary embolism increases with age but the 'classical' presentation of acute pulmonary embolism may not occur in older persons. OBJECTIVES: to compare the clinical presentation of younger and older patients with acute pulmonary embolism. DESIGN: retrospective identification of 60 consecutive cases of spiral computed tomography confirmed acute pulmonary embolism over a 3-year period, with blinded review of radiological films and electrocardiographs, and analysis of clinical presentation. SETTING: a district general hospital serving a population of 200,000 people. SUBJECTS: 31 younger and 29 older patients with acute pulmonary embolism. RESULTS: older persons less often complained of pleuritic chest pain (P < 0.02), particularly as their primary presenting complaint (P < 0.002). Twenty-four percent of older but just 3% of younger persons presented with collapse (P < 0.02), despite similar proportions of central and peripheral emboli in the two groups. Older persons were more often cyanosed (P = 0.05) and hypoxic (P < 0.04) than younger persons but there were no significant differences with respect to heart rate, respiratory rate or mean arterial blood pressure. CONCLUSIONS: older people present atypically with acute pulmonary embolism, potentially leading to delays in diagnosis and initiation of treatment. Collapse is a particularly important symptom of acute pulmonary embolism in older persons, even in the absence of pain.|Aged[MESH]|Aged, 80 and over[MESH]|Cause of Death[MESH]|Chest Pain/etiology[MESH]|Cyanosis/etiology[MESH]|Diagnosis, Differential[MESH]|Electrocardiography[MESH]|Female[MESH]|Humans[MESH]|Hypoxia/etiology[MESH]|Ireland[MESH]|Male[MESH]|Predictive Value of Tests[MESH]|Pulmonary Embolism/*diagnosis/mortality[MESH]|Retrospective Studies[MESH]|Survival Rate[MESH]|Syncope/etiology[MESH]|Tomography, Spiral Computed[MESH] |