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Recent literature suggests conflicting estimates of the prevalence of pulmonary embolism (PE) in patients who present with syncope. Based on these disparate findings, French investigators performed a prospective cohort study of ≈400 patients who presented to seven emergency departments (EDs) with syncope but with no symptoms of chest pain or dyspnea. All patients underwent D-dimer testing, and those with elevated age-adjusted serum D-dimer levels — one third of patients — underwent imaging for PE assessment.
PE was confirmed in nine patients: 6.6% of patients with positive D-dimer results, 2.2% of patients overall, and 18% of patients with cancer (active or cured within prior 12 months). Only one PE was subsegmental.