Pulmonary Embolism

Introduction

Pulmonary embolism is a sudden blockage of an artery in the lung. The blockage is due to a blood clot in the pulmonary artery that carries blood from the heart to the lungs. Pulmonary embolism is considered a potentially life-threatening and serious condition requiring immediate medical intervention. The seriousness of the condition varies with the size of the blood clot. The chance of surviving a pulmonary embolism is greater if you are diagnosed and treated quickly.

Causes

A pulmonary embolism is primarily caused due to a blood clot that originates in the veins that are deep in your muscles (mainly in your legs). This condition is termed as deep vein thrombosis (DVT). The factors that increase the chances of developing DVT and in turn causes pulmonary embolism are genetic inheritance, any major surgery in your medical history, cancer, hip or leg fractures, history of stroke or heart attack, obesity, smoking, taking contraceptive pills, etc.

Symptoms

The common symptoms of pulmonary embolism are sharp chest pain radiating towards your shoulder, neck, arm and jaws; coughing; shortness of breath; sweating; dizziness; restlessness; anxiety; fast heart beat; fainting and feeling lightheaded.

Diagnosis

The doctor first enquires you about your general health condition, medical history and the symptoms. After conducting a physical examination, your doctor may order tests for chest X-ray and ECG. CT scan, ELISA, venography and ultrasound may be required to determine the level of complication. You might also be recommended to undergo pulmonary angiography to get a clear picture of blood vessels.

Treatment

There are various effective treatment methods for pulmonary embolism. Treatment is started immediately after diagnosis of pulmonary embolism to avoid any risk or complications which might lead to death. Oxygen is given immediately to aid the breathlessness. Your vascular surgeon will advise the best treatment option depending on the severity of your condition. Various options include:

Anticoagulants

Your doctor may recommend anticoagulant medication for thinning the blood. Anticoagulants prevent the formation of new clots and break/dissolves up the clots that are already formed.

Filters

Your doctor places medical filters in the large vein (inferior vena cava) by inserting it via a thin tube. This procedure may be recommended if anticoagulants are found insufficient for the treatment. Or, if you are a person where anticoagulant treatment is not preferred (pregnant), then your doctor may prefer treatment with filters.

Cather

This treatment option is called suction thrombectomy and involves insertion of a catheter to deliver a high pressure stream of saline solution to remove and break up the clot. Sometimes instruments on the end of the catheter are also used to mechanically break up the clot.

Surgery

Rarely, your surgeon may recommend removal of clot by a surgery called pulmonary embolectomy if other treatment measures are not effective. Your surgeon uses a catheter to break the clot and facilitate flow of blood.

Prevention

Prevention of pulmonary embolism starts with prevention of DVT. The following steps can be taken to prevent the risk of pulmonary embolism:

  • Practice daily physical exercise and keep yourself active
  • Adapt good eating habits and a healthy life style
  • Compliance with anticoagulant medicines after certain surgeries