Pulmonary Embolism (also known as PE) is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (Deep Vein Thrombosis). Pulmonary embolism can be life-threatening, but prompt treatment can greatly reduce the risk of death. Taking measures to prevent blood clots in your legs will help protect you against pulmonary embolism.
Facts
1. Pulmonary Embolism (PE) is the blockage of a pulmonary artery or one of its branches by a blood-borne blood clot or foreign material.
2. Causes of pulmonary embolism include prolonged immobilization, medications, smoking, genetic predisposition, an increased number of red blood cells (polycythemia), cancer, pregnancy, surgery, or damage to blood vessel walls.
3. If not treated promptly, pulmonary embolism may lead to sudden death.
4. The diagnosis of pulmonary embolism may be difficult to make, and is often missed. Diagnostic strategies need to be individualized to each patient and situation.
5. Anticoagulation medication is the treatment for pulmonary embolism, and the patient may be required to continue treatment for months.
6. Prevention is the best treatment for pulmonary embolism, which can be accomplished by minimizing the risk factors for deep vein thrombosis (DVT).
Causes
1. Pulmonary embolism occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs.
2. These blood clots most commonly originate in the deep veins of your legs, but they can also come from other parts of your body. This condition is known as Deep Vein Thrombosis (DVT).
3. Occasionally, substances other than blood clots can form blockages within the blood vessels inside your lungs. Examples include :
- Fat from within the marrow of a broken long bone
- Part of a tumor
- Air bubbles
Related Article :
- Pleural Effusion [ Pulmonary Effusion ]
- Hemoptysis (Coughing Up Blood)
- Pleural Effusion (PE)
Sign & Symptoms
1. Shortness of Breath (SOB)
2. Chest Pain
3. Cough
4. Leg pain or swelling, or both, usually in the calf
5. Clammy or discolored skin (cyanosis)
6. Fever
7. Excessive sweating
8. Rapid or irregular heartbeat
9. Lightheadedness or dizziness
Diagnosis
Pulmonary Embolism can be difficult to diagnose, especially in people who have underlying heart or lung disease. For that reason, your doctor may order a series of tests to help find the cause of your symptoms. Your doctor may order one or more of the following investigations :
1. Blood tests
Your doctor may order a blood test for the clot-dissolving substance D dimer in your blood. High levels may suggest an increased likelihood of blood clots, although D dimer levels may be elevated by many other factors, including recent surgery. In addition, blood tests may be done to determine whether you have an inherited clotting disorder.
2. Chest X-ray
This noninvasive test shows images of your heart and lungs on film. Although X-rays can't diagnose pulmonary embolism and may even appear normal when pulmonary embolism exists, they can rule out conditions that mimic the disease.
3. Ultrasound
A noninvasive "sonar" test known as duplex ultrasonography (sometimes called duplex scan, or compression ultrasonography) uses high-frequency sound waves to check for blood clots in your thigh veins. In this test, your doctor uses a wand-shaped device called a transducer to direct the sound waves to the veins being tested. These waves are then reflected back to the transducer and translated into a moving image by a computer. The absence of the presence of clots reduces the likelihood of DVT. If the upper thigh vessels are clear, the ultrasonography will also scan the veins behind the knee looking for residual clots. If clots are present, treatment likely will be started immediately.
4. CT scan
Regular CT scans take X-rays from many different angles and then combine them to form images showing 2-D "slices" of your internal structures. In a spiral (helical) CT scan, the scanner rotates around your body in a spiral — like the stripe on a candy cane — to create 3-D images. This type of CT can detect abnormalities within the arteries in your lungs with much greater precision, and it's also much faster than are conventional CT scans. In some cases, contrast material is given intravenously during the CT scan to outline the pulmonary arteries.
5. Pulmonary Angiogram
This test provides a clear picture of the blood flow in the arteries of your lungs. It's the most accurate way to diagnose pulmonary embolism, but because it requires a high degree of skill to administer and has potentially serious risks, it's usually performed when other tests fail to provide a definitive diagnosis.
In a pulmonary angiogram, a flexible tube (catheter) is inserted into a large vein — usually in your groin — and threaded through into your heart and on into the pulmonary arteries. A special dye is then injected into the catheter, and X-rays are taken as the dye travels along the arteries in your lungs.
One risk of this procedure is a temporary change in your heart rhythm. In addition, the dye may cause kidney damage in people with decreased kidney function.
6. MRI
MRI scans use radio waves and a powerful magnetic field to produce detailed images of internal structures. Because MRI is expensive, it's usually reserved for pregnant women (to avoid radiation to the fetus) and people whose kidneys may be harmed by dyes used in other tests.
Treatment
1. The best treatment for a pulmonary embolus is prevention. Minimizing the risk of deep vein thrombosis is key in preventing a potentially fatal illness.
2. The initial decision is whether the patient requires hospitalization. Recent studies suggest that those patients with a small pulmonary embolus, who are hemodynamically stable (normal vital signs) and who can be compliant with treatment, may be treated at home with close outpatient follow-up.
3. Those who are unstable need to be admitted to the hospital.
Medications
A. Blood thinners (Anticoagulants)
B. Clot dissolvers (Thrombolytics)
Surgical and Other Procedures
A. Clot removal. If you have a very large, life-threatening clot in your lung, your doctor may suggest removing it via a thin, flexible tube (catheter) threaded through your blood vessels.
B. Vein filter. A catheter can also be used to position a filter into the body's main vein — called the inferior vena cava — that leads from your legs to the right side of your heart. This filter can help keep clots from being carried into your lungs. This procedure is typically reserved for people who can't take anticoagulant drugs or when anticoagulant drugs don't work well enough or fast enough. The catheter with the filter in the tip is usually inserted in a vein in your neck, and then into the vena cava. Some filters can be removed when they are no longer needed.
References
1. MedicineNet : Pulmonary Embolism
2. Mayo Clinic : Diseases and Conditions : Pulmonary embolism
Related Article :
- Pleural Effusion [ Pulmonary Effusion ]
- Hemoptysis (Coughing Up Blood)
- Pleural Effusion (PE)
Facts
1. Pulmonary Embolism (PE) is the blockage of a pulmonary artery or one of its branches by a blood-borne blood clot or foreign material.
2. Causes of pulmonary embolism include prolonged immobilization, medications, smoking, genetic predisposition, an increased number of red blood cells (polycythemia), cancer, pregnancy, surgery, or damage to blood vessel walls.
3. If not treated promptly, pulmonary embolism may lead to sudden death.
4. The diagnosis of pulmonary embolism may be difficult to make, and is often missed. Diagnostic strategies need to be individualized to each patient and situation.
5. Anticoagulation medication is the treatment for pulmonary embolism, and the patient may be required to continue treatment for months.
6. Prevention is the best treatment for pulmonary embolism, which can be accomplished by minimizing the risk factors for deep vein thrombosis (DVT).
Causes
1. Pulmonary embolism occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs.
2. These blood clots most commonly originate in the deep veins of your legs, but they can also come from other parts of your body. This condition is known as Deep Vein Thrombosis (DVT).
3. Occasionally, substances other than blood clots can form blockages within the blood vessels inside your lungs. Examples include :
- Fat from within the marrow of a broken long bone
- Part of a tumor
- Air bubbles
Related Article :
- Pleural Effusion [ Pulmonary Effusion ]
- Hemoptysis (Coughing Up Blood)
- Pleural Effusion (PE)
Sign & Symptoms
1. Shortness of Breath (SOB)
2. Chest Pain
3. Cough
4. Leg pain or swelling, or both, usually in the calf
5. Clammy or discolored skin (cyanosis)
6. Fever
7. Excessive sweating
8. Rapid or irregular heartbeat
9. Lightheadedness or dizziness
Diagnosis
Pulmonary Embolism can be difficult to diagnose, especially in people who have underlying heart or lung disease. For that reason, your doctor may order a series of tests to help find the cause of your symptoms. Your doctor may order one or more of the following investigations :
1. Blood tests
Your doctor may order a blood test for the clot-dissolving substance D dimer in your blood. High levels may suggest an increased likelihood of blood clots, although D dimer levels may be elevated by many other factors, including recent surgery. In addition, blood tests may be done to determine whether you have an inherited clotting disorder.
2. Chest X-ray
This noninvasive test shows images of your heart and lungs on film. Although X-rays can't diagnose pulmonary embolism and may even appear normal when pulmonary embolism exists, they can rule out conditions that mimic the disease.
3. Ultrasound
A noninvasive "sonar" test known as duplex ultrasonography (sometimes called duplex scan, or compression ultrasonography) uses high-frequency sound waves to check for blood clots in your thigh veins. In this test, your doctor uses a wand-shaped device called a transducer to direct the sound waves to the veins being tested. These waves are then reflected back to the transducer and translated into a moving image by a computer. The absence of the presence of clots reduces the likelihood of DVT. If the upper thigh vessels are clear, the ultrasonography will also scan the veins behind the knee looking for residual clots. If clots are present, treatment likely will be started immediately.
4. CT scan
Regular CT scans take X-rays from many different angles and then combine them to form images showing 2-D "slices" of your internal structures. In a spiral (helical) CT scan, the scanner rotates around your body in a spiral — like the stripe on a candy cane — to create 3-D images. This type of CT can detect abnormalities within the arteries in your lungs with much greater precision, and it's also much faster than are conventional CT scans. In some cases, contrast material is given intravenously during the CT scan to outline the pulmonary arteries.
5. Pulmonary Angiogram
This test provides a clear picture of the blood flow in the arteries of your lungs. It's the most accurate way to diagnose pulmonary embolism, but because it requires a high degree of skill to administer and has potentially serious risks, it's usually performed when other tests fail to provide a definitive diagnosis.
In a pulmonary angiogram, a flexible tube (catheter) is inserted into a large vein — usually in your groin — and threaded through into your heart and on into the pulmonary arteries. A special dye is then injected into the catheter, and X-rays are taken as the dye travels along the arteries in your lungs.
One risk of this procedure is a temporary change in your heart rhythm. In addition, the dye may cause kidney damage in people with decreased kidney function.
6. MRI
MRI scans use radio waves and a powerful magnetic field to produce detailed images of internal structures. Because MRI is expensive, it's usually reserved for pregnant women (to avoid radiation to the fetus) and people whose kidneys may be harmed by dyes used in other tests.
Treatment
1. The best treatment for a pulmonary embolus is prevention. Minimizing the risk of deep vein thrombosis is key in preventing a potentially fatal illness.
2. The initial decision is whether the patient requires hospitalization. Recent studies suggest that those patients with a small pulmonary embolus, who are hemodynamically stable (normal vital signs) and who can be compliant with treatment, may be treated at home with close outpatient follow-up.
3. Those who are unstable need to be admitted to the hospital.
Medications
A. Blood thinners (Anticoagulants)
B. Clot dissolvers (Thrombolytics)
Surgical and Other Procedures
A. Clot removal. If you have a very large, life-threatening clot in your lung, your doctor may suggest removing it via a thin, flexible tube (catheter) threaded through your blood vessels.
B. Vein filter. A catheter can also be used to position a filter into the body's main vein — called the inferior vena cava — that leads from your legs to the right side of your heart. This filter can help keep clots from being carried into your lungs. This procedure is typically reserved for people who can't take anticoagulant drugs or when anticoagulant drugs don't work well enough or fast enough. The catheter with the filter in the tip is usually inserted in a vein in your neck, and then into the vena cava. Some filters can be removed when they are no longer needed.
References
1. MedicineNet : Pulmonary Embolism
2. Mayo Clinic : Diseases and Conditions : Pulmonary embolism
Related Article :
- Pleural Effusion [ Pulmonary Effusion ]
- Hemoptysis (Coughing Up Blood)
- Pleural Effusion (PE)
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