Fainting after air travel may indicate pulmonary embolism

October 22, 2012

Fainting after recent air travel could be a sign of pulmonary embolism (PE), a potentially fatal blockage in the lungs. Syncope or fainting is an uncommon symptom of pulmonary embolism; however, new research presented at CHEST 2012, the annual meeting of the American College of Chest Physicians (ACCP), found that fainting associated with recent air travel may be a key indicator for PE diagnosis. Fainting as a precursor to PE diagnosis was also associated with a saddle embolism, a larger and more life-threatening form of PE, as well as more abnormal ECG readings.

"Fainting may be an atypical symptom of PE, but fainting associated with recent is a dangerous combination," said lead study author Robert Rifenburg, MD, Resurrection Medical Center, Chicago, Illinois. Due to the proximity to Chicago's O'Hare airport, one of the busiest airports in the United States, Resurrection Medical Center sees many sick travelers who are coming directly from the airport. "If you come to our hospital from O'Hare for evaluation of a fainting episode, and you are ultimately diagnosed with a PE as the cause of your fainting episode, the likelihood that this is a life-threatening PE is high."

To determine the connection between fainting and PE, Dr. Rifenburg and colleagues retrospectively reviewed of 548 patients (mean age 68.9) presenting to the (ED) and admitted to the hospital with a new PE over a 5-year period. Data collection included demographics, history, initial chief complaint, location and type of PE, ECG findings, and echocardiography results. Of the patients, 10% (n=55) presented to the ED with fainting as their chief complaint; nearly half of these patients (48%) also reported recent air travel, compared with just 8.1% of patients with PE who did not indicate fainting as a major complaint. The fainting group was also more likely to have a large saddle embolism, as well as a higher incidence of abnormal ECG findings, including nonspecific ST-T wave changes, sinus tachycardia, S1Q3T3 abnormality, and right ventricular hypertrophy.

"A large, saddle emboli can cause sudden hemodynamic compromise resulting in disruption of blood flow to the brain. Anytime you have significant disruption of blood flow to the brain, with or without air travel, you are at a higher risk of losing consciousness," said Dr. Rifenburg.

Earlier this year, the ACCP released Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: Evidence-Based Clinical Practice Guidelines, which addressed the risk of deep-vein thrombosis (DVT) and PE associated with long-distance travel. Although developing a DVT/PE as the result of long-distance travel is unlikely in most cases, the guidelines note that for long-distance flights, several factors may increase the risk of developing a DVT/PE and related complications, including immobility, recent surgery, the use of oral contraceptives, and others.

Although it is unclear if flight length impacted the association of and PE in the current study, Dr. Rifenburg speculates that patients returning from long flights would be at even higher risk for a serious PE.

"Recognizing the risk factors associated with a DVT and PE is essential for effective prevention," said ACCP President-Elect Darcy D. Marciniuk, MD, FCCP. "The ACCP publishes the most comprehensive evidence-based guidelines related to the prevention and management of DVT and PE. Hospitals and clinicians should take active steps to implement the guidelines into practice."

Explore further: New DVT guidelines: No evidence to support 'economy class syndrome'

Related Stories

New DVT guidelines: No evidence to support 'economy class syndrome'

February 7, 2012
New evidence-based guidelines from the American College of Chest Physicians (ACCP) address the many risk factors for developing a deep vein thrombosis (DVT), or blood clot, as the result of long-distance travel. These risk ...

Patients with inflammatory bowel disease appear to be at increased risk for post-operative DVT, PE

October 17, 2011
Patients with inflammatory bowel disease (IBD) undergoing surgery may be more likely to develop deep vein thrombosis (DVT; blood clot in a deep vein in the thigh or leg) or pulmonary embolism (PE; blood clot in blood vessels ...

Aspirin may prevent DVT and PE in joint replacement patients

February 7, 2012
Following a total joint replacement, anticoagulation (blood thinning) drugs can prevent Deep Vein Thrombosis (DVT), a blood clot deep within the extremities, or a pulmonary embolism (PE), a complication that causes a blood ...

Unsuspected PE seldom linked to death in cancer patients

October 9, 2012
(HealthDay)—Unsuspected pulmonary embolism (UPE) is not associated with an increased risk of death in cancer patients when compared to patients without pulmonary embolism (PE), according to research published in the October ...

Risk of pulmonary embolism greatest during first week following total joint replacement

February 7, 2012
The elevated risk of pulmonary embolism (PE) – a blood clot that travels from the leg to the lungs – following total joint replacement (TJR) surgery has been well established, yet little is known about the natural ...

Recommended for you

Snail fever progression linked to nitric oxide production

September 14, 2017
Bilharzia, caused by a parasitic worm found in freshwater called Schistosoma, infects around 200 million people globally and its advance can lead to death, especially in children in developing countries.

Systems analysis points to links between Toxoplasma infection and common brain diseases

September 13, 2017
More than 2 billion people - nearly one out of every three humans on earth, including about 60 million people in the United States - have a lifelong infection with the brain-dwelling parasite Toxoplasma gondii.

Study clears important hurdle toward developing an HIV vaccine

September 13, 2017
An international team of researchers has demonstrated a way of overcoming one of the major stumbling blocks that has prevented the development of a vaccine against HIV: the ability to generate immune cells that stay in circulation ...

As 'flesh-eating' Leishmania come closer, a vaccine against them does, too

September 13, 2017
Parasites that ulcerate the skin, can disfigure the face, and may fatally mutilate its victim's internal organs are creeping closer to the southern edges of the United States.

Promising clinical trial results could give doctors a new tool against drug-resistant strains of malaria parasite

September 13, 2017
Tulane University researchers have developed a new drug that is effective against non-severe cases of malaria, according to results from an FDA-supervised clinical trial published in the latest issue of The Lancet Infectious ...

Semen harbors wide range of viruses

September 13, 2017
(HealthDay)—Human semen provides a potential hiding place and breeding ground for a host of dangerous viruses, a new evidence review reports.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.