Gender Differences in the Symptoms, Signs, Disease History, Lesion Position and Pathophysiology in Patients with Pulmonary Embolism

Abstract

Advances in research relating to pulmonary embolisms (PE) can assist physicians in selecting the best management strategies for PE patients. However, the symptoms, signs, disease history, lesion position and pathophysiology linked to different genders in patients with PE have rarely been evaluated. One hundred and forty-nine PE patients (73 males and 76 females) were sequentially recruited to this study over the last five years whilst attending our Emergency Department. Data relating to the symptoms, signs, disease history, biochemical testing, cardiac electrophysiology, imaging detection, treatment and outcome were collected and the gender differences were analyzed. We found that embolisms occurred significantly more frequently in the right lung (89.7%) than in the left lung (42.6%). The presence of dyspnea, the number of patients presenting with tumors, the number of patients with chronic pulmonary disease, those with emboli in the right pulmonary artery and emboli in the right lung, as well as the average systolic and diastolic blood pressure were: 78.1%, 15.1%, 31.5%, 32.9%, 94.5%, 129.9+20.0 and 75.0+11.2 in the male patients and 59.2%, 1.3%, 14.5%, 17.1%, 69.7%, 125.1+14.6 and 69.3+11.0 in the female patients. These indicators were found to be significantly higher in male patients. In contrast, the rate of V1-V4 T-wave inversion and level of D-dimer in the blood were significantly lower in males than in females. No significant difference was observed in the remaining observational indicators. Gender differences regarding the symptoms, signs, disease history, lesion position and pathophysiology exist in patients with PE and should be considered in clinical practice.

Clinical Significance of ST Elevation in Lead aVR in Acute Pulmonary Embolism

“…The association was much stronger in our study as we report approximately 2.5 times higher death rates in women during hospitalization. In a recent report women have been different from male patients in terms of signs and symptoms on presentation, as well as, the extent and location of the culprit thrombus …”

Crucial considerations: Sex differences in the epidemiology, diagnosis, treatment, and outcomes of acute pulmonary embolism in non‐pregnant adult patients

“…45 Men are also more likely than women to have active or recently treated cancer. [46][47][48] In contrast, women with PE are more likely to have recent immobilization, exogenous estrogen administration, and comorbid atrial fibrillation and congestive heart failure, although this association may reflect that women with PE are on average older than men. 44,47,49 Social determinants of health, such as patterns of exercise, diet, and access to health care also likely contribute to PE risk, but data are limited.…”

Sex‐specific performance of pre‐imaging diagnostic algorithms for pulmonary embolism

“…PE has various sex‐dependent aspects. Differences between women and men in presenting signs and symptoms have been reported . Oral estrogen use is an important women‐specific risk factor for PE .…”