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Pulmonary Embolism

A pulmonary embolus is a potentially life threatening clot that obstructs blood flow to the lungs.

Published April 08, 2011 02:38

Pulmonary Embolism
Pulmonary Embolism

What is a pulmonary embolus?

A pulmonary embolus is a blood clot that lodges in a branch of the pulmonary artery (the pulmonary artery is the main blood vessel from the heart to the lungs). The embolus usually comes from a blood clot that originally formed in a vein in the extremities. This is called a deep vein thrombosis (DVT). A piece of the clot breaks off and travels through the veins into the right side of the heart. The blood clot is pumped through the heart into the pulmonary arteries and the clot eventually becomes caught in a branch of the pulmonary artery, obstructing blood flow to a section of the lung.

What are the symptoms of a pulmonary embolus?

The common symptoms of pulmonary embolus are chest pain and shortness of breath, rapid breathing at rest, or coughing up blood. Many times the person's heart rate will be fast (>100 beats a minute). If the individual has a blood clot (DVT) in their extremity they may have swelling of that arm or leg. Again this is likely where the embolus originated.

Who is at risk for pulmonary embolus?

The risk factors for pulmonary embolus are:
Immobilization or prolonged bed rest
Prolonged travel
Major trauma
Surgery
Medications such as hormones, birth control pills
Inherited or genetic clotting disorders
Dehydration
Pregnancy
Cancer
Prior DVT or pulmonary embolus
Prolonged use of intravenous or central venous catheters

What should I do if I think I might have a pulmonary embolus?

If you are having chest pain that is lasting more than several minutes or progressive unexplained shortness of breath, or racing heart rate, you should call 911 (EMS) or go to the emergency room. Pulmonary embolus can be a life threatening illness that needs immediate attention. It is estimated that a third of people who have an undetected and untreated pulmonary embolus die.

How is a pulmonary embolus diagnosed?

It is important that you see a doctor if you have symptoms that could be from a pulmonary embolus. Sometimes these symptoms are from other conditions. If your doctor suspects you might have a pulmonary embolus, they will order blood work, a chest X-ray, and then other imaging studies, such as a high resolution spiral (helical) CT scan of the chest or a nuclear medicine ventilation / perfusion scan (VQ scan). These studies show if there is an obstruction of blood flow in one or more of the pulmonary arteries in the lungs.

What is the treatment for pulmonary embolism?

The typical treatment for pulmonary embolism requires admission to the hospital and starting blood thinners. These are medications that thin the blood to allow the body's own clotting system to dissolve the clot over time. Patients must be closely monitored while on blood thinners as these place them at risk of bleeding. In certain life threatening situations where there is an extremely large embolus, your doctor might decide to use clot busting medications (thrombolytic agents) or perform an embolectomy (surgical procedure to remove the clot or embolus). Often times, patients will remain on blood thinners for many months after they are diagnosed with a pulmonary embolus. The length of treatment will be determined by your doctor as every patient is different.

Is there anything I can do to lower my risk of pulmonary embolus?

1. While traveling long distances by car or airplane
a. Get up and walk about every hour.
b. While sitting you can rotate your ankles and perform some seated calf raises. These measures improve circulation in the legs.
c. Use compression stockings.
d. Do not cross your legs as this can cut off circulation.

2. Drink plenty of fluids, even while traveling.
3. Talk to your doctor about any medications you may be taking on a regular basis that might place you at risk for a blood clot.
4. If you are having surgery, particularly on the extremities or abdomen, talk to your doctor about what steps can be taken to reduce your risk of blood clots.

The contents of the Health site are for informational purposes only and should not be treated as medical, psychiatric, psychological, health care or health management advice. The materials herein are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. Reliance on any information provided herein is solely at your own risk.

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