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19
Apr
Pulmonary Embolism
A Pulmonary Embolism is a blockage of an artery in the lungs caused by a clot that travels through the bloodstream to the lungs.
Causes
An embolism occurs when a clot moves through the bloodstream from the location where it was formed and becomes stuck in a blood vessel. The clot, called an embolus, can be a blood clot, air bubble, or piece of fat, bone marrow, or tumor tissue.
The embolus in a Pulmonary Embolism is usually a blood clot. It most often starts in a vein in the legs or hips. Once the clot is stuck in a lung, it blocks the blood from nourishing that lung. The tissues on the other side of the blockage die. The lung may become damaged and stop working properly. In severe cases this can lead to death.
Risk Factors
A risk factor is something that increases your chances of getting a disease
or condition.
- Blood clot in a deep vein of a leg or hip
- Prolonged bed rest, such as during a serious illness
- Major surgery
- Injury to a vein in a leg or hip
- Prolonged sitting, such as during a long trip
- Pregnancy
- Birth control pills
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a
physical exam. Tests may include:
Arterial Blood Gas Study – A blood test to identify the levels of oxygen and other gases that are indicators of lung function.
Chest X-ray – A test that uses radiation to take a picture of structures inside the chest.
Lung Perfusion Scan – A test that uses radioactive isotopes to measure breathing and circulation in all areas of the lungs. The presence of an embolus will show as a blockage in that area of the lungs.
CT Scan of the Chest – A type of x-ray that uses a computer to make pictures of the inside of the chest.
Pulmonary Angiogram – X-rays taken after a dye is injected into the blood vessels in the lungs. The test shows areas of blockage in the lungs.
Electrocardiogram (ECG, EKG) – A test that records the heart's activity by measuring electrical currents through the heart muscle.
Additional tests may be done to check blood flow or look for clots in the veins, especially in the legs.
Arterial Blood Gas Study – A blood test to identify the levels of oxygen and other gases that are indicators of lung function.
Chest X-ray – A test that uses radiation to take a picture of structures inside the chest.
Lung Perfusion Scan – A test that uses radioactive isotopes to measure breathing and circulation in all areas of the lungs. The presence of an embolus will show as a blockage in that area of the lungs.
CT Scan of the Chest – A type of x-ray that uses a computer to make pictures of the inside of the chest.
Pulmonary Angiogram – X-rays taken after a dye is injected into the blood vessels in the lungs. The test shows areas of blockage in the lungs.
Electrocardiogram (ECG, EKG) – A test that records the heart's activity by measuring electrical currents through the heart muscle.
Additional tests may be done to check blood flow or look for clots in the veins, especially in the legs.
Treatment
Treatment depends on the size and severity of the clot. Emergency treatment
and hospitalization may be needed. Treatments include:
Medicine
Options include:
In some cases when the blockage is very large, a type of surgery called embolectomy may be done to remove it.
Clot-trapping Filter
A filter is sometimes used to stop clots from moving to the lungs. The filter is placed in the main vein that leads from the legs to the heart and lungs.
Medicine
Options include:
- Thrombolytic medicine to dissolve clots, for example:
- Streptokinase
- Urokinase
- Tissue plasminogen activator (TPA)
- Anticoagulant medicine, called blood thinners, such as heparin or warfarin, to prevent more clots from forming
In some cases when the blockage is very large, a type of surgery called embolectomy may be done to remove it.
Clot-trapping Filter
A filter is sometimes used to stop clots from moving to the lungs. The filter is placed in the main vein that leads from the legs to the heart and lungs.
Prevention
Prevention of pulmonary embolism means preventing clots from forming.
Everyone can help prevent clots with a healthful lifestyle:
Everyone can help prevent clots with a healthful lifestyle:
- Eat a healthful diet, one that is low in total fat as well as saturated fat, and rich in whole grains, legumes, fruits, and vegetables.
- Exercise regularly.
- Walk or move your legs to break up long periods of sitting.
- Take medicine, if your doctor recommends it. Anticoagulant drugs such as warfarin or heparin are most commonly used.
- Wear elastic stockings (also called support hose) to improve circulation in your legs.