Pulmonary Embolism

Pulmonary Embolism General Information

Pulmonary Embolism is the generic medical term given to the situation when an artery in the lungs becomes blocked. In most cases, this is caused by one or several blood clots that may form in other parts of the body and travel through the blood vessels until eventually stopping in the pulmonary artery. It is common that the clots form in the lower limbs, but they may form in the arms or even in the heart. Under some circumstances, blood clots may even form at the tip of a catheter needle that has been placed inside a vein. Other causes are possible as well, but they are much less common occurrences.

In most cases, Pulmonary Embolism is not a lethal condition. However it presents an increasing threat to patients that need to travel long distances via airplane, when proper medical assistance is not available. Taking preventive measures before such trips is highly advised. Also, if the embolism does occur, it is advised that the patient is immediately administered anti-coagulants – this may greatly reduce the risks, and may ensure the survival of the patient. This condition may lead to several further complications in the affected patient. Permanent lung damage may occur. The clots may inhibit the normal gas exchange process, which leads to a lower oxygen level in the affected patient’s blood. This in turn may cause damage to several other internal organs, as they receive insufficient oxygenation.

Pulmonary Embolism Symptoms

There are several symptoms associated with Pulmonary Embolism. However, these may vary from one case to another, as the patient’s organism responds differently according to the size of the clot, the degree of involvement of the lungs and on the patient’s general health condition. Underlying diseases, especially those affecting the lungs or the heart, also have great influence on the presence and nature of the symptoms.

In common cases of Pulmonary Embolism, the patient may experience sudden shortness of breath, regardless whether the patient is resting or performing any physical activities. Chest pains are possible, and often they will resemble heart attacks; they may occur in any area of the chest and while the pain will worsen on physical exertion, it will not cease while resting. The pain may radiate towards the patient’s jaw, neck, shoulder or arms and is also aggravated by breathing deeply, eating or coughing. Also, coughing typically produces bloody sputum. The patient will also experience an increase in their heartbeat, condition known under the name of tachycardia.

Among other symptoms that may be encountered in cases of Pulmonary Embolism, wheezing, excessive sweating and fever are possible. In some cases the patient’s legs may swell, and the skin may take a clammy or bluish hue. Anxiety is rather common in patients affected by this disorder. Lightheadedness, sometimes accompanied by fainting has been noted. Also the patient may present a weak pulse.

Pulmonary Embolism Treatment

In all cases, prompt treatment of the Pulmonary Embolism should be administered in order to prevent the occurrence of further, serious complication or even the death of the patient. Typically the initial treatment for the affection consists of immediate IV or subcutaneous injections of Heparin – an anticoagulant with fast action – which acts by preventing the formation of new clots, as well as the enlargement of existing ones. After that, the examining health care specialist may administer Warfarin, under the form of pills; this drug is also an anticoagulant which stops clot formation, however with slower action. The two medications need to be combined for a few days until the effect of Warfarin is potent enough to prevent clot formation by itself. After the initial clot that has caused the Pulmonary Embolism has been removed or has dissolved, it is likely that the anticoagulant therapy will continue, typically for another three to six months. However, depending on the patient’s state of health, it is possible for the prescribing doctor to advise towards continuing the treatment for an indefinite period, especially in cases where the risk of clot formation is higher.

While following treatment with anticoagulant medication, there is a risk of bleeding complications. The examining health care professional will most likely keep the patient under observation and will require periodic blood tests in order to observe the evolution of the patient’s condition. Also, a large number of drugs may interact with Warfarin and Heparin. It is highly advised that before starting therapy with any other drug, the patient should consult his or her personal health care specialist in order to find out if there are any interactions between the anticoagulants and the new medication.

Other therapies may be employed as well in cases of severe Pulmonary Embolism or in cases where the condition is aggravated by underlying cardiovascular or pulmonary affections. Among these, clot dissolving therapy is commonly applied in such cases; the patient is administered medication that acts by dissolving the already formed clots. Examples of such drugs are Urokinase or Alteplase. They activate a particular enzyme which breaks down the blood clots that have formed within the patient’s body. Therapy with these drugs is not appropriate for certain patients, such as pregnant women or patients suffering from high blood pressure. Pulmonary Embolism patients with recent medical history of strokes or surgery also should not be administered such medication. These drugs increase the risks of bleeding, both from external traumas such as injections or lesions – even brushing one’s teeth may result in gum bleeding – or internally. In some cases severe situations may occur, such as bleeding in the brain, and this may result in the death of the patient.

Another possible preventive therapy implies the insertion of a vein filter which is meant to stop blood clots from traveling to the upper parts of the body from the legs, thus preventing future Pulmonary Embolism. The filter is typically placed in the abdomen, in the inferior vena cava which leads from the pelvis and legs to the right side of the heart. Insertion of the filter is typically made with the aid of a catheter through a vein in the groin or in the neck.