What is a pulmonary embolism? How is it treated?

By | 24 May 2021

Pulmonary embolism is a blockage in one of the lungs due to a clot or other material. In most cases, it is caused by blood clots that form in the legs. Less commonly, clots or other substances that form in other parts of the body can also cause pulmonary embolism. Since the blockage prevents blood flow to the lungs, it can cause very serious life-threatening consequences. However, prompt treatment greatly reduces the risk of death and can lead to a full recovery. It causes serious symptoms such as chest pain, respiratory distress, and bloody cough. Taking measures to prevent blood clots in the legs, called deep vein thrombosis, helps protect against pulmonary embolism.

What is a pulmonary embolism?

Pulmonary embolism is a health problem caused by a blocked blood vessel in the lungs. The condition called pulmonary embolism in medical literature can cause life-threatening consequences if not treated quickly. This blockage in the pulmonary arteries can damage the lungs and other organs that do not get enough oxygen. It is a serious condition and recovery can take weeks or months.

Blood with low oxygen content in the right ventricle of the heart is carried to the lungs by arteries called pulmonary artery. After the lungs are enriched in oxygen, the lung is taken back to the heart through veins. This oxygen-rich blood pumps it to the rest of your body by the heart. If a blood clot is found in one of the arteries that carry blood from the heart to the lungs, it is called a pulmonary embolism. This clot prevents normal blood flow and causes symptoms.

Causes of pulmonary embolism?

Pulmonary embolism often occurs when a material with a blood clot reaches an artery in the lungs and causes an obstruction. These blood clots most often come from deep veins in the legs. This condition is known as deep vein thrombosis (DVT). In most cases, more than one blood clot is seen in the lungs. Lung lobes, where clogged vessels carry blood, are damaged by being deprived of oxygen. This is known as a pulmonary infarction. This damage makes it difficult for the lungs to provide enough oxygen to the rest of the body. Rarely, blockages in blood vessels can be caused by substances other than blood clots. Some of these materials are;

  • Fat, collagen, or other tissue from a broken, long bone marrow
  • Part of a tumor
  • It can be listed as air bubbles.

What are the risk factors for pulmonary embolism?

Although anyone can have a blood clot resulting in pulmonary embolism, some factors cause an increased risk. Risk factors for pulmonary embolism are detailed below.

MEDICAL HISTORY OF THE PATIENT
If the patient or any of his family members have had a venous blood clot or pulmonary embolism in the past, there is a high risk for a new embolism. This condition may be due to inherited disorders that predispose the patient to coagulation disorders. In addition, some medical conditions and treatments seen in the patient cause an increased risk of embolism. Some of these factors are;

  • Cardiovascular diseases. Cardiovascular diseases, especially heart failure, lead to an increased risk of clot formation.
  • Cancer. Pancreatic, ovarian and lung cancers and many types of cancer that spread to distant parts of the body increase the levels of some substances involved in blood clotting, increasing the risk of pulmonary embolism.
  • Chemotherapy. Chemotherapy treatment is another risk factor that increases the risk of clot formation.
  • Surgeries. Surgical applications are one of the leading causes of blood clotting. For this reason, anticoagulant drugs can be given to the patient before and after major surgical interventions.

LONG-TERM STABILITY
Blood clots are more likely to occur during periods of prolonged inactivity, such as:

  • Rest cure. Prolonged bed rest after surgery, heart attack, leg fracture, trauma or any serious illness, makes the person more vulnerable to blood clot formation. When the legs remain horizontal for a long time, the blood flow in the vein slows down and the blood pool in the legs and becomes prone to clotting.
  • Long journeys. Sitting in a cramped position during long-term airplane or car travel slows the blood flow in the legs and examines the formation of clots.

OTHER RISK FACTORS

  • Smoking. Smoking makes some people prone to blood clots, especially when combined with other risk factors.
  • Being overweight. Obesity increases the risk of blood clots, especially in women who smoke or have high blood pressure.
  • Taking estrogen supplements. Estrogen used in birth control pills and hormone replacement therapy increases the risk of pulmonary embolism, especially in smokers or obese women.
  • Pregnancy. The baby’s pressure on the vessels around the uterus can slow the return of blood from the legs. Clots are more likely to occur if blood flow is slowed or if blood is pooling in the leg veins.

What are the symptoms of pulmonary embolism?

Symptoms of pulmonary embolism; It varies greatly depending on how much the lungs are affected, the size of the clots, and whether there is underlying lung or heart disease. Some of the common symptoms and complaints include:

  • Shortness of breath. Characteristically, it appears suddenly and tends to worsen with effort.
  • Chest pain. It may increase when deep breathing, coughing, eating, bending, or standing still. Chest pain gets worse with effort; but it does not go away with rest.
  • Cough. Bloody and phlegm cough may be seen.
  • Pain in the back
  • Excessive sweating
  • Dizziness
  • Dizziness
  • Fainting
  • Blue lips and nails

Other symptoms that may occur with pulmonary embolism can include:

  • Leg pain or swelling that usually occurs in the calf
  • Moist and pale skin (cyanosis)
  • Increase in body temperature
  • Excessive sweating
  • Fast or irregular heartbeat
  • Feeling dizzy or ill

In addition to the symptoms listed, you may experience pain, redness, and swelling in one of your legs (usually in the calf). These are symptoms of blood clot formation in the leg called deep vein thrombosis (DVT), which is the most common cause of pulmonary embolism.

Pulmonary embolism is a life-threatening health problem. For this reason, in complaints such as unexplained shortness of breath, chest pain or cough that causes bloody sputum, 112 should be called immediately or the emergency service should be applied.

How is pulmonary embolism treated?

If pulmonary embolism is suspected to be an emergency, anticoagulant medication is injected into the patient before the desired test results are obtained for a definitive diagnosis. These drugs, called anticoagulants, prevent the growth of existing blood clots and the formation of new clots. If tests confirm the presence of pulmonary embolism, anticoagulant drug injections are continued for at least 5 days. In addition, oral anticoagulant tablet therapy is given for the following 3 months. Full recovery is expected with early diagnosis and treatment. Occasionally, surgery may be required to remove the clot from the lung.

How long does pulmonary embolism treatment take?

Treatment with blood thinners is continued for 3 to 6 months in pulmonary embolism due to deep vein thrombosis. Longer periods of medication should be used in patients with a previous blood clot. If there are risk factors such as cancer treatment, treatment continues as long as the risk factors persist.

What should people with pulmonary embolism pay attention to?

The risk of recurrence of the disease increases in individuals who have had a pulmonary embolism once. There are some precautions that can be taken to avoid the risk of clot formation. For this, it is important to know and follow the symptoms of deep vein thrombosis in the legs. Immediate help should be sought if any of the following symptoms indicative of deep vein thrombosis in the legs are noticed:

  • Swelling
  • pain
  • Precision
  • Increase in heat
  • Rash

Individuals with pulmonary embolism should use blood thinning medications for long periods of time to prevent recurrence. Those who use blood thinners should also pay attention to their diet. For example, it is useful to stay away from foods rich in vitamin K that help blood clot. For this purpose, after obtaining the doctor’s opinion, it may be necessary to limit the consumption of green leafy vegetables rich in vitamin K, fish, liver and some types of vegetable oil.

Many people can walk right after a pulmonary embolism and do light household chores. However, these patients can easily get tired or have breathing difficulties. For this reason, doctors will prescribe special exercises to help patients increase their strength and breathing.

It is helpful to use special stockings known as compression stockings to prevent clot formation in the legs. These stockings become narrower as they descend towards the ankle, which helps the leg muscles move blood up.

Apart from these, it is necessary to get rid of excess weight, to quit smoking, to avoid long journeys unless necessary to prevent pulmonary embolism.

 

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