Overview
A pulmonary embolism is a blood clot that blocks and stops blood flow to an artery in the lung, usually starting in a deep vein in the leg and traveling to the lung. It can be life-threatening, but prompt treatment greatly reduces the risk of death. Common symptoms include rapid or irregular heartbeat, lightheadedness, sweating, fever, leg pain or swelling, and discolored skin. It's important to seek urgent medical attention if experiencing unexplained shortness of breath, chest pain, or fainting.
Understanding the disease
Symptoms
The symptoms of pulmonary embolism can vary, but common symptoms include sudden shortness of breath, chest pain that worsens when taking deep breaths or coughing, feeling lightheaded or dizzy, rapid pulse, rapid breathing, coughing up blood, and sudden, severe headache. If you experience any of these symptoms, seek emergency medical help immediately.
Risk Factors
Risk factors for developing pulmonary embolism include a history of blood clots, medical conditions such as heart disease, cancer, inflammatory bowel disease, and obesity, genetic factors like factor V Leiden, smoking, and certain treatments such as hormone replacement therapy or cancer treatments.
Development
Pulmonary embolism develops when a blood clot forms and travels to an artery in the lung, blocking blood flow. In most cases, the blood clot originates from a deep vein in the leg, but it can also form in a vein in another part of the body. If one or more clots block blood flow to the lungs, it can be life-threatening, but prompt treatment can significantly reduce the risk of death.
Assessment and Diagnosis
Triage
You should see a doctor if pulmonary embolism is suspected, especially if you experience sudden shortness of breath, chest pain or discomfort that worsens with deep breathing or coughing, lightheadedness or dizziness, fainting, rapid pulse, rapid breathing, or coughing up blood. These symptoms indicate that the condition is life-threatening, and prompt medical attention is necessary to reduce the risk of death.
Diagnosis
To diagnose a pulmonary embolism, your healthcare provider will likely discuss your medical history, perform a physical exam, and order tests. Some of the tests that may be used include:
- Blood tests: These can measure the level of D dimer, a clot-dissolving substance, as well as the amount of oxygen and carbon dioxide in your blood.
- Pulmonary angiogram: This is the most accurate way to diagnose a pulmonary embolism but has potential risks, such as temporary changes in heart rhythm and increased risk of kidney damage in people with reduced kidney function.
- Chest X-ray: This noninvasive test can help rule out other conditions with similar symptoms, although it cannot diagnose a pulmonary embolism itself.
- Ultrasound: This noninvasive test uses sound waves to scan veins for deep vein blood clots. It can help diagnose deep vein thrombosis and may be used to guide treatment decisions. Remember that it's important to seek medical attention right away if you suspect you may have a pulmonary embolism. Preparing a list of your symptoms, past medical problems, recent trips, and medications can help your healthcare provider make a accurate diagnosis.
Management and Treatment
Complications
Potential complications of pulmonary embolism include:
- Pulmonary infarction: Blockages in the blood vessels can cause portions of the lung to die due to a lack of blood flow.
- Postphlebitic syndrome: Damage to the veins from blood clots can reduce blood flow in affected areas, leading to complications such as leg pain, swelling, skin color changes, and skin sores.
- Chronic thromboembolic pulmonary hypertension (CTEPH): Long-term high blood pressure in the lung blood vessels can occur due to chronic obstruction from blood clots, leading to right heart failure and reduced quality of life.
- Recurrent pulmonary embolism: Blood clots can recur or new clots can form, increasing the risk of further pulmonary embolism events.
- Death: Pulmonary embolism can be life-threatening if not treated promptly and properly. It is essential to seek urgent medical attention if you experience unexplained shortness of breath, chest pain, or fainting, as these symptoms may indicate a pulmonary embolism.
Prevention
pulmonary embolism can be prevented to a certain extent by taking measures to prevent blood clots in the deep veins of the legs. Prevention strategies include blood thinners (anticoagulants), compression stockings, leg elevation, and maintaining good overall health.
Treatment
Treatments for pulmonary embolism typically involve managing the underlying blood clot and addressing symptoms. The goal is to restore proper blood flow to the lungs and prevent further complications. Some common treatments include:
- Blood-thinning medications: Anticoagulants, such as heparin or warfarin, are often used to dissolve blood clots and prevent new clots from forming. These medications can be administered intravenously or orally, depending on the severity of the condition.
- Thrombolytic therapy: In some cases, a medication called a thrombolytic drug may be used to dissolve blood clots. This treatment is usually reserved for severe cases or when blood clots are causing life-threatening symptoms.
- Oxygen therapy: If oxygen levels in the blood are low due to the pulmonary embolism, oxygen therapy may be provided through a mask or nasal tube to help the body better absorb oxygen.
- Pain management: Medications can be prescribed to alleviate chest pain and other symptoms, such as headache or muscle aches.
- Compression stockings: Wearing compression stockings can help reduce swelling and improve blood flow in the legs, which may help prevent further blood clots.
- In rare cases, surgical intervention may be necessary to remove blood clots or repair damaged blood vessels. It is essential to seek urgent medical attention if you suspect a pulmonary embolism, as prompt treatment can significantly reduce the risk of serious complications or death.
Preparing for medical consultation
To prepare for an appointment for pulmonary embolism, you should:
- Be aware of any pre-appointment restrictions and ask about them when you schedule the appointment.
- Write down a detailed description of your symptoms and any recent trips that involved long car or plane rides.
- List your past medical problems, especially any recent surgeries, injuries, or illnesses that kept you in bed for several days.
- Make a list of all medications, vitamins, herbal products, and supplements you're taking, including doses.
- Gather any previous scans or X-rays and other relevant medical records.
- Write down key personal information, including a family history of heart disease, aneurysms, or connective tissue disease.
- Consider bringing a family member or friend for support.
- Be prepared to discuss your diet, exercise habits, and tobacco use.
- Send any relevant imaging reports to your health care provider in advance.
- Write down a list of questions to ask your health care provider during the appointment. Remember to be open and honest with your healthcare provider about your symptoms and medical history. This will help them make an accurate diagnosis and develop an appropriate treatment plan for your pulmonary embolism.