Pulmonary Embolism

PULMONARY EMBOLISM

Last Updated December 20th, 2021

Introduction

Blood circulation within the body involves two distinct cycles or circuits. The first and shorter of the two is known as the pulmonary cycle. This is followed by the systemic cycle.

Deoxygenated blood collected by veins from all parts of the body is finally returned to the right side of the heart. The pulmonary cycle begins when the right ventricle of the heart pumps this venous blood into the lungs by means of the pulmonary artery. This is done so that the deoxygenated blood can again be refreshed with oxygen received from the alveoli of the lungs. When this is done, oxygenated blood from the lungs now travels to the left side of the heart. This completes the pulmonary circuit.

Oxygenated blood is now pumped by the left ventricle of the heart into the aorta which distributes it to all parts of the body through the arterial system and capillaries. Deoxygenated blood is then collected by veins and brought back to the right side of the heart once again. This second phase is known as systemic circulation.

 

What Is Thromboembolism?

The efficiency of blood circulation is dependent on the smooth and unobstructed flow of blood through arteries, veins, and capillaries. Oftentimes, our arteries become clogged with the deposition of a cholesterol plaque. This can make it difficult for blood to flow through. Other times, there may be a rupture or injury to an artery delivering blood to a certain organ or tissue, starving those cells of the oxygen and nutrients that they need. Yet another possibility is that the blood vessels could become blocked with a blood clot. The clot may have formed at the site itself or it may have been carried to the spot from elsewhere in the body. The latter situation is referred to as thromboembolism.

 

What Is Pulmonary Embolism?

PULMONARY EMBOLISM bleedingPulmonary embolism is one of the best-known examples of thromboembolism. It occurs when a blood clot carried along by the blood becomes firmly lodged in an artery in the lung.

One of the primary causes for this is a condition known as deep vein thrombosis.

Pulmonary embolism typically results in symptoms such as breathlessness and lightheadedness because the heart, and thereby the rest of the body, is unable to receive the oxygen-rich blood it needs in order to continue functioning.

This condition can have severe long-term consequences and it can also be fatal if the patient is not attended to in time.

 

 

What Causes Pulmonary Embolism?

This condition generally arises as a complication of deep vein thrombosis. The latter involves the formation of a blood clot in one of the deep veins of the body, usually in the legs. This clot, or a piece of it, may come loose. It will then be carried along by the bloodstream, passing through the venous system until it finds its way into the pulmonary artery. It the clot is large enough, it can become lodged in the pulmonary artery or one of its branches, obstructing the flow of blood into the lungs.

Another way in which this can happen is when small clots progressively accumulate in the various branches of the pulmonary artery. The actual cause of the obstruction need not necessarily be a blood clot. It can also be an air bubble or a fat globule.

PULMONARY EMBOLISMRisk factors for deep vein thrombosis are applicable for pulmonary embolism as well:

  • Damage to the walls of the veins. This can happen when you have a habit of smoking.
  • Prolonged bed rest or immobility.
  • Having a family history of blood clots.
  • History of deep vein thrombosis or pulmonary embolism.
  • Trauma. This can include surgical trauma as well.
  • Hormone replacement therapy.
  • Having a blood clotting disorder.
  • Dehydration.
  • Heart disease.
  • Lung disease.
  • Vasculitis.
  • Hepatitis.
  • Inflammatory bowel disease.
  • Cancer.
  • Hughes syndrome.
  • Obesity.
  • Taking oral contraceptives.
  • Being pregnant.
  • Having varicose veins.
  • Taking chemotherapy or radiation therapy.

 

What Symptoms Are To Be Expected?

Sometimes, the onset of symptoms is relatively gradual. It tends to begin with shortness of breath which can intensify progressively. Eventually, the patient also develops chest pain which can be quite severe. Sometimes, the condition is minor and temporary. The clot creating the obstruction may be small and it may resolve on its own. In instances of air or amniotic fluid embolism, the offending substances may get reabsorbed, resolving the obstruction.

When a person suffers from a pulmonary embolism, he or she may experience the following problems:

  • Breathlessness.
  • Chest pain.
  • Breathing rapidly.
  • Elevated heart rate.
  • Weak pulse.
  • Irregular heartbeat.
  • Feeling faint or lightheaded.
  • Dizziness.
  • Bluish discoloration of the skin.
  • Feeling restless or anxious.

 

What Are Some Likely Complications?

Pulmonary embolsim lungsThere can be a range of severe consequences when you have a pulmonary embolism. Receiving immediate medical help reduces the likelihood of developing complications. However, when the condition goes unrecognized or untreated, patients often do not survive.

The loss of blood supply to a certain section of lung tissue, unless promptly relieved, can cause permanent death of that section of tissue. This is known as infarction. When small clots accumulate progressively over an extended period of time, the patient will generally develop a condition known as pulmonary hypertension. This refers to elevated blood pressure within the lungs and even the right side of the heart. As a result, the patient could develop cardiac failure which may lead to death.

There is also the possibility of recurring embolism. Once the obstruction has been resolved, it can return unless the underlying problem has been rectified.

For instance, those who have suffered from one case of deep vein thrombosis are at a higher risk of experiencing a recurrence. And the more often that clots appear in the deep veins, the greater the likelihood of giving rise to pulmonary embolism.  

 

How Is Pulmonary Embolism Diagnosed?

It is not very easy to correctly identify the condition based only on its symptoms. Hence, the patient may need to undergo specialized imaging tests. These will help to precisely locate the obstruction. The following procedures may be involved:

  • Physical examination.
  • Medical history.
  • D-Dimer test, a specialized blood test.
  • Ultrasound.
  • Echocardiogram.
  • Pulmonary angiogram.
  • Computerized tomography (CT).

 

What Is The Best Treatment? Is it preventable?

The first step involves making a correct diagnosis of the condition, identifying the nature and composition of the obstruction and the underlying cause for it. In case the blockage has been caused by blood clots, the immediate course of action would be to administer blood thinners to prevent more such clots from being formed. Some patients may require thrombolytic drugs in order to break down large clots.

Pulmonary embolism can develop swiftly and without prior warning. It is a medical emergency. However, the condition can also take on a chronic form and develop gradually as smaller clots pile up in the arteries of the lungs. The patient may notice progressive shortness of breath and chest pain. This can lead to high blood pressure in the lungs and heart which can cause more severe complications such as heart failure. Certain risk factors are modifiable and patients should take care to avoid these in order to prevent repeated occurrences.

 

Facts

  • Pulmonary embolism or deep vein thrombosis (PE/DVT) affects around 900,000 people in the United States every year.
  • Pulmonary embolism or deep vein thrombosis (PE/DVT) is the cause of death of around 100,000 individuals in the United States each year.
  • A big pulmonary embolus can immediately cause the death of a person.

Facts

  • It is estimated that the percentage of deaths (within one month of diagnosis) of individuals affected by PE/DVT is around 10% to 30%.
  • Sudden death is the first symptom experienced by 25% of the individuals having a pulmonary embolism.

Facts

  • It is estimated that the approximately 33% (about one-third) of individuals affected by PE/DVT experience recurrence within 10 years.
  • It is estimated that approximately 4% to 10% of the surgical oncology patients develop pulmonary embolism without any prophylaxis; out of these cases, around 1% to 5% are fatal.

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Dos and Don'ts

Dos
  • Use compression stockings (tight and long stockings) or inflatable boots that’s help in squeezing the muscles of the lower leg and improve blood circulation.
  • As soon as possible after a surgery, get out of the bed and start walking in order to prevent the formation of blood clots.
  • Do leg exercises and move around more during flight journeys in order to prevent blood clots.
Don'ts
  • Miss the dosage of blood thinners prescribed after surgeries.
  • Ignore symptoms such as shortness of breath, chest pain, fainting or light-headedness.
  • Neglect the regular follow-up sessions after the surgery.

 

 

 

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Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
Isagenix diet weight loss
How are BMI and BMR different and what do these numbers mean? BMI and BMR are two important metrics that provide a clear picture of your body's metabolism and also…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
BoneMarrow-Biopsy
Bone Marrow Biopsy Bone marrow biopsy is a diagnostic procedure where a small amount of bone marrow is extracted from hip…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
Tight phimosis ring
Phimosis Read to know everything about phimosis, types, symptoms, treatment, risks and prognosis for patients with this condition.
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…