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Pulmonary Embolism
Medical Questions » Pulmonary Embolism
| Name: Pulmonary Embolism |
| Also known as: Lung Clot; Pulmonary Thromboembolism |
| Occurs when a blood clot or other substance (embolus eg. fatty plaque from high cholesterol) travels through the blood to a small artery in the lung (pulmonary artery) which it then blocks. |
Causes of Pulmonary Embolism
Blood clots may occur in the veins of leg muscles (see Deep Venous Thrombosis), but may also arise in other parts of the body. They travel through veins to the right side of the heart, and then into the lungs where they cut off the blood supply to a segment of lung which will collapse and die. More common after major surgery, in patients who are bedridden for long periods, and in the elderly. |
Symptoms of Pulmonary Embolism
Chest pain, shortness of breath, coughing of blood, fainting, heart rate increases, and a fever. |
Tests for Pulmonary Embolism
Diagnosed by chest X-ray or CT scans. Blood tests can show signs of clotting within the body, and an electrocardiogram (ECG) shows strain on the heart. Specialized tests of lung function are sometimes necessary. An X-ray in which dye is injected into the veins and can be seen moving through the arteries in the lung may be performed in cases of doubt. |
Treatment for Pulmonary Embolism
Must start as soon as possible to prevent extension of the clot and further damage to the lung. Anticoagulants drugs that prevent blood clotting (eg. heparin) are initially given as an injection, and later as tablets (eg. warfarin, aspirin). Regular blood tests are performed throughout treatment with anticoagulants to check the dosage required. Anticoagulant therapy is continued for some months after the attack, but in high risk patients it may be continued for life. In severe cases thrombolytics (clot dissolving drugs) are injected directly into the involved veins. In rare circumstances, surgery to remove the clot from the lungs or leg is undertaken, or a filter is inserted surgically into the main vein of the body leading from the legs to the heart, to filter out any blood clots that may form in the future. Blood clots in the legs can be prevented by using pressure stockings during long operations, early mobilization after surgery, physiotherapy to keep leg muscles active, and elevation of the legs in bed-bound patients.
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Complications of Pulmonary Embolism of its treatment
Increased back pressure of blood on the heart may lead to right heart failure (cor pulmonale). An extending clot can cut off more pulmonary arteries, and destroy a larger area of lung. |
Likely Outcome of Pulmonary Embolism
Rapid death occurs in 10% of patients who have a large area of lung involved, but the majority of patients recover provided appropriate treatment is given quickly. |
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