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PULMONARY EMBOLISM

Pulmonary embolism (PE) is a blockage in one of the pulmonary artery that supplies blood to the lungs. It is one of the most common cardiovascular problems that restricts the blood flow to the lungs. Pulmonary embolism usually occurs due to the blood clots that are most commonly developed in the blood vessels of legs or rarely form the other parts of the body. These blood clots travel through the circulatory system to reach the lungs, which results in the decreased oxygen levels in the blood. Pulmonary embolism can affect other organs and can be life-threatening. Multiple blood clots can often be fatal as they decrease the blood supply.

Signs and symptoms

The signs and symptoms of pulmonary embolism include:

  • Shortness of breath
  • Sharp chest pain
  • Irregular heartbeat
  • Fainting
  • Heart palpitations
  • Coughing up blood-streaked or foamy mucus
  • Rapid breathing
  • Anxiety
  • Excessive sweating
  • Discolored skin
  • Lightheadedness

Causes

Pulmonary embolism is caused due to a blood clot that occurs in a deep vein of the leg. These clots travel through the bloodstream and block the pulmonary artery. Deep vein thrombosis is the main underlying cause of pulmonary embolism.

Risk factors

The factor that increases the risk of developing pulmonary embolism are:

  • Medical History: Having a history of heart attack or stroke or a history of autoimmune disease, cancer, kidney disease can contribute to PE.
  • Weight: Being overweight increases the risk of blood clots.
  • Surgeries: Surgical procedures involve a risk of developing blood clots, which contribute to PE.
  • Lifestyle: Prolonged immobilization or sedentary lifestyle leads to poor blood circulation.
  • Medications: Birth control pills enhances clot formation, thus increasing the risk of PE.
  • Smoking: Smoking raises the risk of pulmonary embolism.
  • Cancer: Individuals having cancer or receiving chemotherapy are at higher risk of developing pulmonary embolism.
  • Family history: Inherited traits of blood clotting disorders can cause PE.
  • Blood pressure: People having high blood pressure are prone to the risk of PE.

Complications

The following are the serious complications that can occur due to pulmonary embolism:

  • Inadequate blood flow to the lung tissue can lead to pulmonary hypertension.
  • Lack of oxygen can damage other organs in the body.
  • Too large or multiple blood clots can be fatal.
  • Cardiac arrest due to the presence of blood clots.
  • Pleural effusion (buildup of fluid between the lining of lungs and chest cavity)

Diagnosis

The doctor would perform a physical examination and may enquire about the symptoms, overall health condition and family history. He would also take a history of chest pain and shortness of breath.

The following are the tests recommended to diagnose pulmonary embolism:

  • Blood test: Blood test is done to measure a substance known as D-dimer, which is released when the blood clots breakdown. High levels of D-dimer indicates the presence of a blood clot.
  • Chest X-rays: These X-rays are useful to generate the images of lungs and the internal organs.
  • Ultrasound scan: It helps to visualize the residual clots and check the blood flow in the veins.
  • Computed tomography (CT) scan: CT scan is a three-dimensional imaging procedure, which enables to view the blood clots in the lungs.
  • Ventilation-perfusion scans: These scans are used to diagnose PE, where a small amount of radioactive substance is injected into the bloodstream to track and examine the blood flow.
  • Pulmonary angiography: Pulmonary angiography is performed by inserting a catheter through the veins to check for the location of blood clots. A special dye is used to visualize the blood vessels of the lungs.

Treatment

The treatment of pulmonary embolism aims to prevent the formation of new blood clots and serious complications.

Medications: Anti-coagulants are commonly known as blood thinners, heparin and warfarin are the most commonly used drugs to treat pulmonary embolism. However, these medications do not dissolve the blood clots but prevent the formation of new clots.

Thrombolytic therapy: Thrombolytics are used to dissolve large blood clots during life-threatening situations. This therapy is used only during the emergency situations as it can increase the risk of serious bleeding complications.

Inferior vena cava filter: Vena cava is a large vein that carries blood from the lower body to the heart. A vena cava filter is inserted into the inferior vena cava (large vein), which prevents the blood clots from traveling to the lungs.

Embolectomy: Embolectomy is a surgical procedure for the removal of clots. A thin flexible tube known as a catheter is inserted through the blood vessels to remove the large clots.

Prevention

The following are the tips to prevent pulmonary embolism:

  • Move your lower limbs regularly.
  • Avoid staying inactive for a longer duration of time.
  • Choose healthy food choices and drink adequate amounts of water.
  • Maintain a healthy weight by exercising regularly.
  • Quit smoking as it can increase the risk of developing pulmonary embolism.
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