A pulmonary embolism, or PE, is a blood clot that has lodged in the lung. It occurs when the clot breaks free from a vein (such as in the calf, which is also known as a deep vein thrombosis) and passes through the body's veins on its way back to the heart, where it is then pumped into the pulmonary artery that feeds blood to the lungs. The clot then blocks the blood flow to the lungs, causing several symptoms, including: shortness of breath, an increased heart and breathing rate, coughing or coughing up blood, and/or sharp chest pain that worsens with breathing.
There are several risk factors for developing a pulmonary embolism, which include inherited and acquired causes. Inherited thrombophilias are a group of genetic disorders that allow the blood to clot more easily than usual. These comprise protein C or S and antithrombin deficiencies or factor V Leiden or prothrombin gene mutations. These are usually discovered when someone has a deep vein thrombosis (DVT) or PE without a known cause like surgery or prolonged periods of inactivity. Some individuals also have an increased amount of clotting factors, such as factor VIII.
Other conditions that increase the risk of a pulmonary embolism are: cancer, smoking, obesity, pregnancy, increased age, medications (including birth-control pills, hormone-replacement therapy and tamoxifen), heart failure, and kidney disease. Surgeries of the knee, hip and pelvis, along with prolonged periods of inactivity during recovery or long trips without movement, also increase the risk of a PE.
A pulmonary embolism is diagnosed via a complete history, physical examination, blood tests and imaging (such as a spiral CT scan, ventilation/perfusion lung scan, or pulmonary angiography). Once discovered, the PE is treated with anticoagulation medications like heparin, low -molecular-weight heparin, fondaparinux and coumadin. Thrombolytic therapy may be performed, or surgery may be used to remove the clot if medical therapy is ineffective or too risky. The duration of medical treatment could be as short as 3 months or last indefinitely; depending on the cause of the clot.
Prevention of DVTs is paramount in the prevention of pulmonary embolisms. If a patient will be undergoing surgery and is at a high risk of developing a DVT, anticoagulants can be given to decrease that risk. Also, after surgery, some patients will use inflatable spontaneous-compression devices that fit around the calf. These appliances inflate and deflate, promoting circulation of the blood and therefore decreasing the DVT risk.
Travelers who will be sitting for prolonged periods of time should also take precautions to avoid DVT formation. Move around often as possible--at least once per hour--including flexing and extending the foot. Other prevention suggestions include quitting smoking, avoiding tight clothing, wearing knee-high stockings and staying hydrated.
If you have any troubling symptoms or are at a high risk of developing a DVT or PE, please speak to your health-care provider as soon as possible
What You Need to Know About Pulmonary Embolism
Nov 18, 2009 | By
