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Review
. 2022 Aug 21;11(16):4916.
doi: 10.3390/jcm11164916.

Pulmonary Embolism Presenting with Pulmonary Infarction: Update and Practical Review of Literature Data

Giulia Gagno  1 , Laura Padoan  2 , Stefano D'Errico  3 , Elisa Baratella  4 , Davide Radaelli  3 , Alessandra Lucia Fluca  1 , Alessandro Pierri  1 , Milijana Janjusevic  1 , Elena Aleksova Noveska  5 , Maria Assunta Cova  4 , Roberto Copetti  6 , Franco Cominotto  6 , Gianfranco Sinagra  1 , Aneta Aleksova  1
Affiliations
Review

Pulmonary Embolism Presenting with Pulmonary Infarction: Update and Practical Review of Literature Data

Giulia Gagno et al. J Clin Med. .

Abstract

Pulmonary infarction (PI) is a possible consequence of pulmonary embolism (PE). The real incidence of PI could be underestimated considering only non-fatal PE presentation. However, following postmortem examination, the prevalence of PI is considerably higher. This evidence suggests the necessity of proper diagnostic protocol for identifying PI. Unfortunately, PI diagnosis can sometimes be challenging, due to the overlapping of symptoms with other diseases. Nowadays, the diagnosis is mainly based on radiological evaluation, although the combination with emerging imaging techniques such as ultrasound and nuclear scanning might improve the diagnostic algorithm for PI. This review aims to summarize the available data on the prevalence of PI, the main predisposing factors for the development of PI among patients with PE, to resume the possible diagnostic tools, and finally the clinical and prognostic implications.

Keywords: diagnostic algorithm; pulmonary embolism; pulmonary infarction; pulmonary ultrasound.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a,b) CT of typical “bubbly consolidation” with central lucencies, indicated by red circles. (c) CT pulmonary angiography shows a filling defect within a segmental artery of the right lower lobe (acute pulmonary embolism). (d) Typical findings of a pulmonary infarction are better recognizable on images reconstructed with a parenchymal filter: a peripheral pleural-based consolidation with convex borders (Hampton hump) and small central clearance, without air bronchogram in the lower right lobe.
Figure 2
Figure 2
(a) Small (11 × 9 mm) subpleural consolidation detected at lung echography. Clear pleural discontinuity with the underlying hypoechoic area. (b,c) Typical ultrasound appearance of “bubbly consolidation” with a roundish hyperechoic area in the context. Arrows indicate the consolidation at lung echography.
Figure 3
Figure 3
Flow diagram showing the proposed algorithm for the diagnosis of pulmonary infarction in case of pulmonary embolism. * As diagnosed via current guidelines. CTPA, computed tomography pulmonary angiography; PE, pulmonary embolism; PI, pulmonary infarction.
See this image and copyright information in PMC

References

    1. Kaptein F.H.J., Kroft L.J.M., Hammerschlag G., Ninaber M.K., Bauer M.P., Huisman M.V., Klok F.A. Pulmonary infarction in acute pulmonary embolism. Thromb. Res. 2021;202:162–169. doi: 10.1016/j.thromres.2021.03.022. - DOI - PubMed
    1. Kirchner J., Obermann A., Stuckradt S., Tushaus C., Goltz J., Liermann D., Kickuth R. Lung Infarction Following Pulmonary Embolism: A Comparative Study on Clinical Conditions and CT Findings to Identify Predisposing Factors. Rofo. 2015;187:440–444. doi: 10.1055/s-0034-1399006. - DOI - PubMed
    1. Islam M., Filopei J., Frank M., Ramesh N., Verzosa S., Ehrlich M., Bondarsky E., Miller A., Steiger D. Pulmonary infarction secondary to pulmonary embolism: An evolving paradigm. Respirology. 2018;23:866–872. doi: 10.1111/resp.13299. - DOI - PubMed
    1. Tapson V.F. Pulmonary infarction: A disease of the (mostly) young. Respirology. 2018;23:805–806. doi: 10.1111/resp.13366. - DOI - PubMed
    1. Zanon M., Valentinuz E., Montanaro M., Radaelli D., Manfredi A., Bonuccelli D., Martelloni M., D’Errico S. Is hospital autopsy auditing suitable for clinical risk management? Actualities and perspectives of auditing in the autopsy room following Italian Law 24/2017 on patient safety. Curr. Pharm. Biotechnol. 2020;22:1964–1970. doi: 10.2174/1389201021666201208115525. - DOI - PubMed