Pulmonary Embolism

PULMONARY EMBOLISM (PE)

A pulmonary embolism is a blood clot that blocks and stops blood flow to an artery in the lung. This happens when a clot in another part of your body (often your leg or arm) moves through the veins to your lung thus restricts blood flow to your lungs, lowers oxygen levels in your lungs and increases blood pressure in your pulmonary arteries.

This venous clot travels all the way into the inferior vena cover, enters into the right upper chamber of the heart (right atrium) then passes through the tricuspid valve into the right lower heart chamber, pulmonary valve then finally blocks the blood flow in pulmonary artery.

How serious is a pulmonary embolism?

With proper diagnosis and treatment, a PE is seldom fatal. However, an untreated PE can be serious, leading to other medical complications, including death. About 33% of people with a pulmonary embolism die before they get a diagnosis and treatment.

A pulmonary embolism can:

Cause damage to your lungs.
Cause strain on your heart, causing heart failure.
Be life-threatening, depending on the size of the clot.

How common is a pulmonary embolism?

Pulmonary embolism is one of the most common heart and blood vessel diseases in the world. It ranks third behind heart attack and stroke.

Symptoms

Symptoms of pulmonary embolism vary, depending on the severity of the clot. Although most people with a pulmonary embolism experience symptom, some don’t.

Pulmonary embolism symptoms may include:

Sudden shortness of breath — whether you’ve been active or at rest.
Unexplained sharp pain in your chest, arm, shoulder, neck or jaw. The pain may also be similar to symptoms of a heart attack.
Cough with or without bloody mucus.
Pale, clammy or bluish skin.
Rapid heartbeat (pulse).
Excessive sweating.
In some cases, feeling anxious, lightheaded, faint or passing out.
Wheezing.

Causes

Pulmonary embolism causes include:

People who are immobile, spending most of the time sitting, patient hospitalized for a long period of time (Bed Ridden), passengers on a plane and others
Patients with vessel injury namely due to fall, accidents, cuts, recent surgeries.
Another medical condition, such as cardiovascular disease (including congestive heart failure, atrial fibrillation, heart attack or stroke).
An increase or decrease in your blood’s clotting factors. Elevated clotting factors can occur with some types of cancer or in some people taking hormone replacement therapy or birth control pills. Abnormal or low clotting factors may also happen as a result of blood clotting disorders.

Risk factors

People at risk of developing a PE include those who:

Have a blood clot in their leg, or deep vein thrombosis (DVT).
Are inactive for long periods of time while traveling via motor vehicle, train or plane (such as a long, cross-country car ride).
Have recently had trauma or injury to a vein, possibly after a recent surgery, fracture or from varicose veins.
Are taking birth control pills (oral contraceptives) or hormone replacement therapy.
Currently smoke.
Have a history of heart failure or stroke.
Have overweight (a Body Mass Index or BMI greater than 25)/obesity (a BMI greater than 30).
Are pregnant or have given birth in the previous six weeks.
Received a central venous catheter through their arm or leg.
Smokers

Complications

Cardiac arrest

When your heart suddenly stops beating, the condition is known as cardiac arrest, so Cardiac arrest is a problem with your heart’s electrical system. A PE can cause cardiac arrest. And when this happens, the risk of premature death is high.

Pleural effusion

Pleural effusion is also known as “water on the lungs.” It’s a condition in which fluid builds up in between the layers of pleura, which are thin membranes that surround the lungs. Symptoms include shortness of breath, a dry cough, and chest pain.

Pulmonary infarction

One of the most serious complications of a PE is a pulmonary infarction — the death of lung tissue. It occurs when oxygenated blood is blocked from reaching lung tissue and keeping it nourished. Typically, it’s a larger clot that causes this condition. Smaller clots can break up and be absorbed by the body.

Arrhythmia

An arrhythmia is a term to describe any abnormal heart rhythm. An exceedingly fast heartbeat is called tachycardia. A heartbeat that is chaotic and caused by unpredictable quivering of the heart’s upper chambers (atria) is called atrial fibrillation.

Pulmonary hypertension

It’s critical to treat a PE, because if left untreated, it can lead to pulmonary hypertension. That’s another term for high blood pressure in the arteries in your lungs.

Prevention

Ways to prevent a pulmonary embolism include:

Exercise regularly. If you can’t walk around, move your arms, legs and feet for a few minutes every hour. If you know you’ll need to sit or stand for long periods, wear compression stockings to encourage blood flow.
Drink plenty of fluids, but limit alcohol and caffeine.
Don’t use tobacco products.
Avoid crossing your legs.
Don’t wear tight-fitting clothing.
Lose weight if you have overweight.
Elevate your feet for 30 minutes twice a day.
Talk to your provider about reducing your risk factors, especially if you or any of your family members have had a blood clot.

Diagnosis

Chest X – Ray
Pulmonary Angiography
Echocardiography
D-Dimers
Complete Blood Count
ESR
Electrocardiogram

Pulmonary Embolism