V/P scan in diagnosis and follow-up of pulmonary embolism in 15-25-year-old females in relationto hormonal contraception use.
Abstrakt
An analysis of medical records of young females who were examined in our department during a five-year period (2005-2009) on suspicion of pulmonary embolism (PE) in relation to hormonal contraception (HC). The patient sample included 86 young females aged 15-25 (mean 21) years who underwent a ventilation/perfusion scintigraphy (V/P scan).
Seventeen of them were examined repeatedly. Altogether, 114 scintigraphic examinations were performed.
Lung perfusion scintigraphy was performed using a planar gamma camera (Mediso MB 9200) in 4 projections following 100 MBq 99mTc - MAA i.v. application with 81mKr ventilation scintigraphy concurrently. In our group of patiens who underwent a P/V scan, 42% of those on HC were diagnosed with PE on scintigraphy, compared to 10% of those not taking HC.
Among the patients with PE, there were 10/24 (42%) young females with persistent postembolic changes. Our study indicates that the well-known risk of venous thromboembolism related to the use of HC needs to be considered as a cause of PE even among very young females.
In our experience, prevention of these life-threatening conditions in patients with a family history of venous thromboembolism consists of timely examination of their thrombotic profile and selection of appropriate contraception.