Persistent dyspnea, exercise limitation and impaired health-related quality of life in patients surviving pulmonary embolism

The only long-term consequence of pulmonary embolism (PE) has for long been considered to be chronic thromboembolic pulmonary hypertension, which does not affect more than 2-4%. Recently some studies have revealed that up to 50% of PE patients may suffer from persistent dyspnea, limited exercise capacity and reduced quality of life long after their diagnosis. The aims of the thesis were to describe the effects of PE from the patients’ perspective by studying the prevalence of persistent dyspnea, exercise capacity limitation and impaired quality of life in a cohort of PE-patients long after their diagnosis. Furthermore, the thesis explored possible factors which could be associated with these outcomes. Patients with a history of PE were invited for a study visit which included clinical examination, exercise capacity test and filling out quality of life questionnaires. Persistent dyspnea was reported by 47% of the patients. Fifty-six percent of the patients reporting dyspnea had abnormal exercise capacity test compared to only 40% of patients with no dyspnea. Quality of life was found to be significantly lower in patients with PE compared to the general population. Furthermore, patients reporting dyspnea had lower quality of life score than those without dyspnea, a difference which was found to be significant. Interestingly, comorbidities such as heart failure and lung disease, could not fully explain the high prevalence of persistent dyspnea. More importantly, there was a significant association between persistent dyspnea, reduced exercise capacity and impaired quality of life. Overall, these findings imply that a far larger proportion, than previously recognized, of PE-patients suffer from residual dyspnea after their diagnosis and that persistent dyspnea seem to affect the patients global well-being