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Pulmonary embolism

What is a pulmonary embolism?

Pulmonary embolism refers to a condition where the blockage in one of the pulmonary arteries occurs. The most common cause of a pulmonary embolism is the blood clots that travel from the veins to the lungs.

Blood clots can damage tissues of the lungs due to less or restricted blood flow, lower oxygen levels in the blood, and impact on other organs as well. Multiple or large blood clots can be fatal.

Blood clots block the blood flow to the lungs, hence pulmonary embolism can be a life-threatening condition. However, the risk of death can be reduced by using an immediate emergency treatment.

Causes of Pulmonary embolism

The formation of a blood clot can be caused by various reasons. Pulmonary embolism is more often caused by deep vein thrombosis, a medical condition in which the blood clots form in the deep veins in the body. The blood clots that most often because pulmonary embolism starts in the pelvis or leg.

There are several different causes of a blood clot in deep veins.

Pulmonary embolism causes include:

Damage or trauma: trauma including muscle tears, a bone fracture may cause damage to blood vessels that leads to a blood clot.

Inactivity: During a long period of inactivity, the blood stagnates in the lowest areas of the body it is caused by gravity and may lead to a blood clot. This may occur if you are in a sitting position for a long time or on if you are at bed rest.

Medical conditions: Blood clots can form easily in some health conditions ant that will lead to pulmonary embolism. Treatment like Surgery and chemotherapy for cancer can also cause blood clots.

Pulmonary embolism risk factors

Though anyone can have blood clots and subsequent pulmonary embolism, certain factors may increase the risk.

Factors that increase the risk of developing pulmonary embolism and deep vein thrombosis include:

Pulmonary embolism risk factors:

  • Cancer
  • Family history of pulmonary embolism
  • Fractures of the leg or hip
  • Genetic disorders that cause blood clotting such as factor V Leiden, prothrombin gene mutation, and higher levels of homocysteine
  • A history of heart attack or stroke
  • Major surgery
  • Obesity
  • A sedentary lifestyle
  • Age over 60 years
  • Taking estrogen or testosterone

What are the symptoms of a pulmonary embolism?

Symptoms may vary according to the size of blood clots, how much lung is involved, and if you have underlying lung or heart disease.

Shortness of breath is the most common pulmonary embolism symptom.

Other Pulmonary embolism symptoms and signs may include:

  • Chest pain
  • Cough
  • Anxiety
  • Cyanosis
  • Lightheadedness
  • Rapid breathing
  • Irregular heartbeat
  • Restlessness
  • Low pulse rate
  • Fainting
  • Spitting up blood


How is a pulmonary embolism diagnosed?

Pulmonary embolism can be difficult to diagnose in some cases, this happens in case of underlying heart condition or lung disease for example emphysema and high blood pressure.

Your doctor will ask about your overall health and pre-existing conditions you may have. Your doctor recommends you some tests to learn the cause of your symptoms.

Diagnosis of pulmonary embolism include:

Chest X-ray: A chest x-ray gives the detailed image of your lungs, heart as well as ribs.       

Electrocardiography (ECG): An ECG will measure the heart’s electrical activities.

Magnetic resonance imaging (MRI): MRI produces a detailed image of internal structures by using radiofrequency and magnets.

CT scan: A computed tomography (CT) scan gives the cross-sectional images of the lungs.

Pulmonary angiography: In this test, your doctor can guide specialized tools through your veins by making an incision, and they will also inject a special dye so that the blood vessels of the lung can be visualized.

Duplex venous ultrasound: This test uses sound waves to see the blood flow and to check the blood clots in your legs.

Venography: In this procedure X-ray of the veins is taken after injecting dye by using a catheter (long plastic tube).

Another diagnosis of pulmonary embolism includes-

Blood tests:

Your doctor may advise a blood test to check the clot-dissolving substance called D dimer. High levels may indicate an increased likelihood of blood clots, though other factors can also cause higher levels of D dimer.

Blood tests are also giving the measurement of the amount of carbon dioxide and oxygen in your blood. A clot in a blood vessel of your lung can cause a low oxygen level in your blood.

Additionally, blood tests are also used to determine whether you have an inherited clotting disorder.

How is a pulmonary embolism is treated?

The treatment for pulmonary embolism is based on the size and location of the blood clot. Medications are used as treatment if you are diagnosed early and your condition is mild. Some medicines may break up the clots.

The medicinal treatment for pulmonary embolism that may be prescribed include:

Anticoagulants: These are also known as blood thinners; the drug heparin and warfarin prevent the formation of further clots in your blood. They may be used for saving lives in an emergency situation.

Thrombolytics (clot dissolvers): These drugs show results by speeding up the breakdown process of blood clots. They are typically saved for emergency conditions because side effects may include serious bleeding problems.

Surgery can be important to remove clots that cause problems such as restriction of the blood flow to the lungs and heart. The surgical procedures that might be performed by your doctor for the treatment of pulmonary embolism include:

Vein filter: In this procedure, your doctor will make a small incision and then use a thin tube to install a narrow filter in your inferior vena cava. The filter restricts the blood clots from traveling to your lungs from your legs.

Clot removal: In this procedure a catheter used for suction of large blood clots out of your artery.

Open surgery: Open surgery used only in emergency conditions like when a person is in shock or medications stop working to break up the blood clot.

How a pulmonary embolism can be prevented?

To prevent a pulmonary embolism, you need to prevent the formation of the clot in your veins of the legs. The methods of prevention include:

  • Drugs such as blood thinners (anticoagulants)
  • Compression stockings
  • Leg elevation
  • Physical activity
  • Pneumatic compression


Preventions while traveling

  • Drink plenty of fluids
  • Don’t sit for too long
  • Flex your ankle in every 15-30 minutes
  • Wear support stockings

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