Pulmonary embolism is a life threatening condition, which is caused by pulmonary artery blockage. Pulmonary artery treatment depends on the size and location of a blood clot. If a quality medical care is provided in due time, the survival rate improves by several times. How not to miss the warning signs and symptoms of this disease, as well as how to get the treatment in good time, you may read in detail below.
The lungs are the 2 organs in the chest that are primarily responsible for the uptake of oxygen and the removal of carbon dioxide from the blood. The lungs are made up of clusters of small air sacs (alveoli) divided by thin, elastic walls (membranes). Within these membranes between the alveoli, run the capillaries, the tiniest of blood vessels, which allow blood and air to come very near to each other without actually touching. The distance between the air in the lungs and the blood in the capillaries is so tiny that it allows the molecules of oxygen and carbon dioxide to transfer across membranes. The exchange of the air between the lungs and blood are through the arterial and venous system.
Although arteries and veins both carry and move blood throughout the body, the process for each of them is vastly different. If a blood clot forms in one of the veins in your body (deep vein thrombosis or DVT), it can potentially break off and enter the circulatory system and travel can then become lodged in one of the branches of the pulmonary artery in the lung. A pulmonary embolus clogs the artery that provides blood supply to part of the lung, preventing not only the exchange of oxygen and carbon dioxide, but also decreasing blood supply to the lung tissue itself, potentially causing lung tissue to die (infarct). A pulmonary embolus is a life-threatening cause of chest pain and should always be considered when experiencing shortness of breath and chest pain. There are special types of pulmonary embolus that are not due to blood clots, but rather, are due to other body materials such as:
- Fat emboli from a broken thigh bone (femur)
- An amniotic fluid embolus (during pregnancy)
- Tumor tissue from cancer
What are the risk factors for a pulmonary embolism?
Factors that heighten your risk of developing deep vein thrombosis and pulmonary artery blockage include the following:
- Fractures of the leg or hip
- Age over 60 years
- Taking testosterone or estrogen
- A family history of embolisms
- Hypercoagulable states or genetic blood clotting disorders, including Factor V Leiden, prothrombin gene mutation, and elevated levels of homocysteine
- A history of heart attack or stroke
- Major surgery
- A sedentary lifestyle
SYMPTOMS OF PULMONARY EMBOLISM
- The sudden shortness of breath.
- Sharp chest pain that worsens when you cough or breathe deeply
- A cough that brings up pink, foamy mucus
More general symptoms can also be a result of a pulmonary artery blockage (pulmonary embolism). For example, you may feel lightheaded or faint, anxious or on edge or you may sweat a lot or even experience a fast heart rate or heart palpitations. If you are experiencing any of the aforementioned symptoms, you need to seek immediate medical attention, especially if they come on suddenly and are severe.
PULMONARY EMBOLISM TREATMENT OPTIONS
The treatment of your pulmonary embolism will depend on the size and location of the blood clot. If the problem is minor and caught in the early stages, medication can be an effective treatment as some drugs can break up small clots.
Drugs your doctor may prescribe include:
- Anticoagulants (blood thinners): Heparinand warfarin are drugs that can prevent new clots from forming in your blood. They can also save your life in an emergency.
- Clot dissolvers (thrombolytics): These drugs speed up the breakdown of a clot and are typically reserved for emergency situations only as the side effects may include dangerous bleeding.
Surgical procedures for pulmonary embolism treatment
Problematic clots that that restrict blood flow to the lungs or heart may need to be surgically removed.
- Vein filter: Your doctor will make a small incision, then use a thin wire to insert a small filter in your inferior vena cava, the main vein leading from your legs to the right side of your heart. This filter prevents blood clots from traveling from your legs and into your lungs.
- Clot removal: A thin tube called a catheter will suction large clots out of your artery, however, because of the difficulty involved, so it’s not always a preferred method of treatment.
- Open surgery: Open surgery involves the removal of a clot and is known an embolectomy. An embolectomy might be done during a surgery or with a minimally invasive procedure that uses a catheter. This type of treatment for pulmonary embolismis used only in very rare circumstances. It is reserved only for people who can’t have other kinds of treatment or those whose clot is so dangerous that waiting for medicine to work is not an option. An embolectomy also may also be possible for those whose condition is stable but showing signs of significant reduction of blood flow in the pulmonary artery.
DIFFERENT METHODS USED TO DIAGNOSE PULMONARY EMBOLISM
Diagnosing pulmonary embolism can be difficult, as there are many of the symptoms can be caused by other medical conditions, such as a heart attack or an anxiety attack. Diagnosis depends on an accurate and thorough medical history as well as ruling out other conditions. This information, combined with a careful physical examination will point to the initial tests that are best suited to diagnose deep vein thrombosis or a pulmonary embolism. Tests that are often performed if you are experiencing shortness of breath or chest pain include:
- A chest X-ray: An enlarged heart or pneumonia may be ruled out as the cause of your symptoms. If the chest X-ray is normal, further testing may be needed.
- Electrocardiogram(EKG, ECG): This test records the electrical activity of your heart. EKG results will help rule out the possibility of a heart attack.
- Arterial blood gas analysis: A sudden drop in the blood oxygen level may suggest there is a pulmonary embolism present.
Further testing may include:
- D-dimer: A D-dimer bloodtest measures a substance that is released when a blood clot These levels are usually spike in people with pulmonary embolism.
- CT (computed tomography) scan or CT angiogram: A pulmonary embolism or blood clot may be discovered by using this method of testing.
- Magnetic resonance imaging (MRI): This test may be ordered to view clots in the lungs.
- Doppler ultrasound:A Doppler ultrasound test uses reflected sound waves to determine whether the large veins of the legs have any blood clots in them.
- Echocardiogram: This test detects abnormalities in the size or function of the heart’s right ventricle. This can be a sign of pulmonary embolism.
- Ventilation-perfusion scanning: Once a radioactive tracer has been injected and you inhale a radioactive gas, this test scans for abnormal blood flow through the lungs.
- Pulmonary angiogram: This invasive test is done only in rare cases to diagnose pulmonary embolism.
After your doctor has determined that you have a pulmonary embolism, other tests can help to guide the treatment process as well as suggesting the likelihood of your recovery. These tests may include:
- A blood test to check the level of the hormone brain natriuretic peptide (BNP): Higher levels of BNP indicate that your heart is under increased pressure.
- A blood test to look at the level of the protein troponin: Higher levels of troponin can mean your heart muscle has become damaged.