Epidemiology, Risk Factors and Diagnostic Features of Acute Pulmonary Embolism in a Moroccan Tertiary Cardiology Department: A Retrospective Descriptive Study

Abstract

Background: Acute pulmonary embolism (PE) constitutes a leading cause of illness and death from cardiovascular disease around the world. Even with better ways to diagnose and treat PE, it is still difficult to manage, especially in places where local data are limited. In Morocco, there is little recent hospital-based information about the clinical characteristics of patients admitted with acute PE. Aim: This study aims to describe the epidemiology, risk factors, clinical presentation, and diagnostic features of patients with acute PE admitted to the cardiology department at Ibn Rochd University Hospital. Methods: A retrospective descriptive study of consecutive patients admitted to the cardiology department of Ibn Rochd University Hospital, Casablanca, conducted for acute PE confirmed by CTPA between January 2024 and December 2025. Demographic characteristics, thromboembolic risk factors, clinical presentation, electrocardiographic findings, echocardiographic features, and CTPA findings were extracted from medical records and analysed descriptively. Results: Fifty-four patients were included, with a mean age of 60 ± 18 years (range 22–88); 58% were women. At least one provoking or contributing factor was found in 98% of patients. Prolonged immobilisation was the most common risk factor, present in 81% of cases. Obesity, recent surgery, hormonal exposure or postpartum status among women, active cancer, chronic heart disease or chronic respiratory disease, history of miscarriage by females, prior history of venous thromboembolism, were all reported to be risk factors for pulmonary embolism. The most common presenting symptom was dyspnea, followed by chest pain (98%), and ECG changes were frequently observed (S1Q3 pattern [50%], anterior T-wave inversions [44%], and sinus tachycardia [37%]). A right ventricular dilation was observed in 65% of participants via an echocardiogram, systolic dysfunction was also seen in 48% of patients, and all cases were confirmed on a CTPA. Proximal emboli were noted in 72% of patients and 69% of patients demonstrated bilateral involvement. Conclusion: In this single-centre Moroccan study, acute PE occurred mainly in middle-aged and older adults and was slightly more common in women. Identifiable thromboembolic risk factors were frequent, especially immobilisation, obesity, surgery, cancer, and hormonal exposure. CTPA was the basis of diagnosis, while echocardiography provided important information on right ventricular involvement. The results show the need for better prevention, earlier diagnosis, and larger multicenter studies on pulmonary embolism in Morocco.