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Pulmonary Embolism

Pulmonary embolism (PE) is when a blood clot becomes lodged in a blood vessel of the lungs, blocking blood flow. It can be deadly if not treated quickly enough.

Symptoms

The symptoms of PE can vary depending on where the clot is in the lungs and a person’s overall health. Not everyone has every symptom. These include:

  • Breathing very hard and fast
  • Feeling short of breath
  • Sudden loss of consciousness (fainting)
  • Chest pain
  • Anxiety
  • Sweating
  • Coughing
  • Feeling that the heart is beating very fast or out of rhythm
  • Low blood pressure
  • Dizziness

Causes

The clot which forms a pulmonary embolus usually starts elsewhere in the body, often in a vein in the leg. In rare cases, it can start in the arm. Sometimes a clot in the arm or leg stays put, but other times, it breaks off and goes to another location in the body. If it becomes trapped in the lungs, it’s called a pulmonary embolus.

Clots can also form because of:

  • Heart attack
  • Stroke
  • Heart conditions which cause an irregular heartbeat such as atrial fibrillation
  • Breaking a large bone (most commonly, a leg or pelvis)
  • Recent surgery
  • Certain medications
  • Inactivity, such as with long plane or car rides, or in cases of bedrest
  • A genetic predisposition to clotting
  • A disease which causes blood to clot

Risk Factors

The primary risk factor for developing a blood clot is sitting or lying still for a long time. This is why it’s advised that people get up and move around from their airplane seat at least every two hours while on a long plane ride. The same thing should be done for other types of transportation, such as long car rides, bus rides, or train rides.

Other risk factors include:

  • Recent Covid-19 infection
  • Pregnancy or recent birth
  • Surgery
  • Being overweight or obese
  • Taking hormonal birth control or hormone replacement therapy
  • Smoking
  • Patients who have had a heart attack or stroke
  • Family members who have had a blood clot

Diagnosis

A healthcare provider may request the following tests to diagnose a PE:

  • Blood tests
  • CT scan of the chest
  • VQ scan of the chest – a special type of scan for people who cannot take contrast
  • Angiogram of the chest or lung vessels- a scan which injects a special dye in the blood vessels to show abnormalities

Complications

Pulmonary embolus is a serious health condition and can cause death if not treated.

Other complications can include:

  • Pulmonary hypertension – high blood pressure in the lungs
  • Heart failure – the heart has to push harder than normal to move blood
  • Part of the pulmonary embolus breaking off and going to another area of the body
  • Scarring of the blood vessels in the lung where the clot lodged

Treatment

There are several options for treatment. Depending on how quickly the PE was diagnosed and a patient’s other medical conditions, one or more of the following may be recommended:

  • Blood thinning medications: oral medications which prevent more clots from forming and the original clot from getting bigger
  • Fibrinolytic therapy: medication given through a cannula to dissolve the clot
  • Vena cava filter: a metal filter placed in a large vessel in the body to catch clots before they can travel to the lungs
  • Percutaneous thrombectomy: Using an x-ray machine for guidance, a doctor threads a small wire through blood vessels into the clot. It can then be used to break up the clot
  • Surgical removal of the clot

Prevention

The best prevention for pulmonary embolism is to not get a clot in the first place. Eating nutritious food, exercising regularly, and not smoking help. Follow all instructions for movement after a surgical operation and take all medications as prescribed. Do not forget to stand from seats and walk at least every two hours on long-haul trips.

 
 
 

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