The autopsy findings and clinical features in 60 patients with fatal p
ulmonary embolism (PE) in University College Hospital, Ibadan, between
1985 and 1989 are analysed in the current study. Pulmonary embolism o
ccurred in 3,8 pc of all autopsied patients during this period. There
was a male to female ratio 1,4 to one and average age was 47 years. Ma
lignant neoplasms, infections and cardiac failure were the leading pre
disposing factors to PE identified. The ante-mortem clinical features
consisted largely of non-specific respiratory symptoms of dyspnoea, co
ugh, chest pain and haemoptysis. Of these patients, 15,6 pc were diagn
osed ante-mortem as having PE. Pulmonary infarction occurred in 13,3 p
c of the cases and was commoner in females and in patients with underl
ying cardiac diseases. This study emphasises the need for a high clini
cal index of suspicion to improve the antemortem diagnosis of this pot
entially fatal condition and to advocate a greater use of prophylactic
anti-coagulant therapy in high risk patients.