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Pulmonary Embolism - Symptoms, Causes and Treatments

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Pulmonary Embolism - Symptoms, Causes and Treatments

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Pulmonary embolism occurs when a lump, most commonly a blood clot, gets stuck in an artery in the lung, which stops the blood supply to the lung.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At September 14, 2019
Reviewed AtSeptember 26, 2023

Introduction:

‘Embolism’ means plug or stopper in Greek. A blockage in the artery that supplies the blood to the lungs (pulmonary artery) is called pulmonary embolism. It affects around 1 in 1,000 people in the United States and is one of the most common cardiovascular diseases. It can be fatal, as it prevents oxygen from reaching the lungs.

The block or embolus is most commonly a blood clot. An embolus can form in one part of the body and block the blood flow to other parts by traveling through the blood vessels which is called an embolism. A thrombus (thrombosis), unlike an embolus, forms, and stays in the same place. Prompt treatment can prevent complications and reduce death rates.

What Are the Symptoms of Pulmonary Embolism?

The symptoms of pulmonary embolism depend on the amount of lung involved, the size of the embolus, and the existing heart and lung conditions. The symptoms include:

  • Difficulty breathing, which gets worse with exertion.

  • Chest pain that gets worse with a deep breath, cough, exertion, and bending.

  • Cough with or without bloody or blood-streaked sputum.

  • Calf pain or swelling.

  • Bluish discoloration of the skin (cyanosis).

  • Clammy skin.

  • Fever.

  • Profuse sweating.

  • Irregular heartbeat.

  • Dizziness.

  • Restlessness.

If one finds it difficult to breathe and has chest pain, then it is necessary to seek immediate medical help, as they are also signs of a heart attack.

What Causes Pulmonary Embolism?

Pulmonary embolisms often occur due to the formation of blood clots that block the deep veins in the body, which is called deep vein thrombosis. These blood clots usually originate in the arteries of the legs or pelvis, and result from:

  • Blood vessel damage is caused by bone fractures or muscle tears.

  • Long periods of inactivity result in blood clots as blood stagnates in the lowest areas of the body due to gravity.

  • Medical conditions that make the blood clot easily.

Apart from blood clots, sometimes, the blood vessels can get blocked by:

  • Collagen.

  • A segment of a tumor.

  • Air bubbles.

  • Fat dislodged from a fractured bone.

What Are the Risk Factors for Pulmonary Embolism?

Factors that increase the risk of developing deep vein thrombosis (DVT) and pulmonary embolism include:

  • Cancer.

  • A positive family history.

  • After a major surgery.

  • Sedentary lifestyle.

  • Older adults.

  • Taking hormones like estrogen or testosterone.

  • Fracture of a major bone like hip or thigh.

  • Obesity.

  • People with blood clotting disorders like Factor V Leiden and elevated levels of homocysteine.

  • Previous heart attack or stroke.

  • Prolonged bed rest.

  • Sitting in a single position during a trip.

  • Smoking.

  • Pregnancy.

What Are the Complications of Pulmonary Embolism?

Some of the common complications of pulmonary embolism are as follows:

  • Heart Attack - The embolus can block the major blood vessels of the heart, which might result in a heart attack. It is a medical emergency.

  • Pleural Effusion - Collection of fluid between the layers that surround the lungs.

  • Pulmonary Infarction - It occurs when a portion of lung tissue dies, as the blood supply is cut off.

  • Arrhythmia - Pulmonary embolism makes the right side of the heart work harder, which results in abnormal heart rhythm or arrhythmia.

  • Pulmonary Hypertension - Increased blood pressure in the arteries of the lungs.

How Is Pulmonary Embolism Diagnosed?

An underlying heart or lung disease like hypertension or emphysema makes diagnosing pulmonary embolism difficult. The doctor will ask about the overall health and any pre-existing conditions, and might ask the individual to get one or more of the following tests done:

  • Blood Test - To detect clot-dissolving substance D dimer in the blood.

  • Chest X-ray - The heart and lungs can be seen in detail.

  • Electrocardiography (ECG) - To measure the electric activity of the heart.

  • MRI (Magnetic Resonance Imaging) And CT (Computed Tomography) Scan - To see detailed and cross-sectional images of the heart and lungs.

  • Pulmonary Angiogram - Here, specialized tools are passed through the veins and a dye is injected. The dye helps doctors see the blood vessels of the lungs.

  • Duplex Venous Ultrasound - Here, soundwaves are used to detect any clots in the veins.

  • Venography - It is a special type of X-ray, which shows the veins of the legs.

What Are the Treatment Options for Pulmonary Embolism?

Depending on the size and location of the blood clot, the doctor will plan your treatment. Small clots can be broken up with medicines like:

  • Blood thinners - Anticoagulants or blood thinners prevent the formation of a new clot. Examples are Warfarin and Heparin.

  • Thrombolytics - Otherwise called clot dissolvers, help break down clots. It is used only in case of an emergency.

For clots that cause serious blood flow restriction to the heart and lungs, surgery may be necessary. The surgical options are as follows:

  • Clot Removal - The clot is removed using a thin, flexible tube inserted through the blood vessels.

  • Vein Filter - A small filter is installed in the main artery of the heart through a small incision. This filter prevents blood clots from reaching your lungs from your legs.

  • Open Surgery - Open surgery is done in emergencies.

Some natural ways to dissolve blood clots include consumption of the following foods and drinks:

  • Pineapple.

  • Kiwi.

  • Ginger.

  • Kale.

  • Grape juice.

  • Spinach.

  • Turmeric.

  • Red wine.

What Are Ways to Prevent Pulmonary Embolism?

If one has any of the factors that increase the risk of pulmonary embolism, then the following can be done to prevent blood clots:

  • Drinking plenty of water prevents dehydration and blood clots.

  • Do not consume alcohol as it helps fluid loss.

  • Compression stockings help promote blood circulation to your legs.

  • Avoid sitting for long hours while traveling or working. Take frequent breaks or flex your ankles every 15 to 30 minutes.

Conclusion:

Pulmonary embolism is a condition that causes the blood clot to obstruct and cease the blood flow to an artery in the lung. In a majority of cases, the blood clot develops in a deep vein in the leg and moves to the lung. The formation of clots in veins in other parts of the body is rare. The underlying cause has to be treated, after treatment for pulmonary embolism. The doctor will prescribe blood thinners to prevent more blood clots. If left untreated, pulmonary embolism could result in serious medical complications and can even cause death.

Frequently Asked Questions

1.

How painful is a pulmonary embolism?

Pulmonary embolism causes sharp pains, which gets worse with each breath. Such chest pain does not get better with rest. It can also cause difficulty breathing and rapid heart rate.

2.

How dangerous is a pulmonary embolism?

A PE can be fatal if the embolus blocks the blood flow to major organs like the heart and lungs. It can also damage other organs.

3.

What are some natural ways to cure a pulmonary embolism?

Foods that help reduce blood clots are turmeric, ginger, peppers, vitamin E rich foods, garlic, grape seeds, cinnamon, and Bromelain (an enzyme extracted from pineapple).

4.

Can a person survive a pulmonary embolism?

Prompt diagnosis and treatment of pulmonary embolism reduce the fatality rate. But most often, this condition goes undiagnosed because of underlying heart or lung disease, which results in the death of one-third of people with PE.

5.

Who is at high risk for pulmonary embolism?

People with deep vein thrombosis (DVT), which is a blood clot in the deep vein like the leg, are mostly affected by PE. The factors that increase the risk of DVT are cancer, fracture, sedentary lifestyle, obesity, smoking, pregnancy, and people older than 60 years.

6.

Can pulmonary embolism go away on its own?

Small clots can get cleared on its own by the body. The body activates a protein called plasmin, which is present in the clot. This plasmin, once activated, breaks down the clot.

7.

How long can you live with a pulmonary embolism?

The survival rate depends on the size of the embolus. The first week after the clot has formed is the risk period. If you survive that, the clot might take months to years to dissolve. You might have to live with shortness of breath, pulmonary hypertension, and exercise intolerance.

8.

How serious is a pulmonary embolism?

The survival rate of PE is between 77 % and 94 %. A large embolus can block the blood supply to the lungs, which can reduce the blood oxygen levels. This, in turn, affects other organs.

9.

What happens if a pulmonary embolism goes untreated?

An embolus can dissolve on its own. But in some cases, if PE is left untreated, it can cause heart attack, pleural effusion, pulmonary infarction, arrhythmia, pulmonary hypertension, and death.
Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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