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PULMONARY EMBOLISM (PE)

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PULMONARY EMBOLISM (PE)

Pulmonary embolism is a condition characterized by a sudden blockage of an artery in the lungs usually by a blood clot that breaks loose and travels through the bloodstream.

  • Pulmonary embolism can be life-threatening especially if the clots are many or if a clot is large. This is because the clot will block blood flow to the lungs.
  • If undiagnosed or left untreated, the blockage can result in death. However, immediate emergency treatment decreases the chance of permanent lung damage.
  • Estimates show that about one-third of people with untreated and undiagnosed pulmonary embolism don’t survive.
  • The condition most often results from a blood clot in the leg that travels up through the right side of the heart and into the lungs.
  • The condition occurs in both male and female, and become more common as people get older.
  • Pulmonary embolism can result in complications such as pulmonary hypertension, a condition in which the blood pressure in the right side of the heart and the lungs becomes too high.

CAUSES

Pulmonary embolism occurs when substances, especially blood clot, gets wedged into an artery in the lungs. Blood clots can form for different reasons. In pulmonary embolism, blood clots are often caused by deep vein thrombosis, a condition in which blood clots form in veins deep in the body. The blood clots that result in pulmonary embolism usually begins in the pelvis or legs.

Other substance that can cause blockage may include:

  • Part of a tumor
  • Air bubbles
  • Fat from the marrow of a broken long bone
  • Collagen or other tissue

Certain factors that can put an individual at more risk of developing the condition include:

  • Cancer
  • Heart disease
  • Surgery
  • Prolonged immobility such as seen in bed rest and long trips.
  • Smoking
  • Pregnancy
  • Obesity
  • Supplemental estrogen
  • A family history of embolism
  • Fractures of the legs or hips

SYMPTOMS

  • Shortness of breath
  • Cough
  • Chest pain
  • Fever
  • Leg pain or swelling
  • Irregular or rapid heartbeat
  • Excessive sweating
  • Dizziness
  • Discolored skin

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will order the following tests:

  • Blood tests for clot-dissolving substance D dimer. High levels of this substance may be indicative of an increased likelihood of blood clots. Blood tests can also measure the amount of carbon dioxide and oxygen in the blood. If a clot is present in a blood vessel in your lungs, it may lower the oxygen level in your blood.
  • A chest X-ray to show images of your heart and lungs in order to rule out conditions that mimic pulmonary embolism.
  • An ultrasound procedure known as duplex ultrasonography to check for blood clots in your thigh veins.
  • A pulmonary angiogram to provide a clear picture of the blood flow in the arteries to the lungs.
  • Spiral CT scan
  • MRI
TREATMENT

Treatment options aim at keeping the blood clot from enlarging and preventing the formation of new clots. To prevent serious complication or death, prompt treatment is essential.

Treatment options are:

Medications such as

  • Blood Thinners
  • Clot dissolvers

Surgery to remove problematic clots. Surgical procedures that may be used includes:

  • Open surgery
  • Clot removal
  • Vein filter