This Is What Happens With Pulmonary Embolism
A clot from one part of the body traveling the bloodstream to another part of the body is an embolus. Pulmonary embolism (PE) is abrupt blockage of arterial circulation in the lungs, when an embolus obstructs blood flow in an artery. This occurs in the main pulmonary artery, carrying blood from the heart to the lungs, or in one of the smaller arteries.
In 50% of cases, blockage is a blood clot initiating in the deep veins of the body, usually the legs, called deep vein thrombosis (DVT). The DVT goes to the right side of the heart, and lodges in the pulmonary artery. Other sources are an air bubble from a central vein catheter, amniotic fluid dislodged in labor, foreign bodies like talc used during IV drug use, septic emboli as in acute endocarditis, or tumor cells. When a large bone (like a thigh bone) breaks, fat from bone marrow in the blood, reaches the lungs, and can cause PE.
PE causes lung damage from death of lung tissue (pulmonary infarction). A massive PE puts stress on the right ventricle and stops the entire circulatory system, triggering cardiopulmonary arrest and death. Left untreated, 30 % of patients die, and 3% – 8% of those who are treated die within 30 days. Those who die do so within the first few hours of the event.
Symptoms include: shortness of breath (dyspnea), rapid breaths (tachypnea), chest pain, coughing or coughing up blood (hemoptysis), leg pain and/or swelling, low-grade fever, bluish skin (cyanosis), wheezing, sweating, anxiety, fainting (syncope), rapid pulse (tachycardia), arrhythmia (irregular heartbeat), abnormal lung sounds (rales) or an abnormal fourth heart sound. With a massive PE, there may also be signs of shock (cold and clammy skin, weak pulse, low blood pressure). Some people have feelings of impending doom (anxiety, dread, light-headedness, fainting, tachypnea, sweating, tachycardia).
Computed tomography (CT) scans look for blood clots. Dye injected that is into an arm vein makes blood vessels in the lungs and legs show up on x-ray images. The patient lies on a table, and an x-ray tube will rotate around them. The tube takes pictures from many angles. This test allows doctors to detect most cases of PE. The test only takes a few minutes. Results are available shortly after the scan is done.
Thrombolytic medications dissolve clots, but theses medicines can cause sudden bleeding and are used only in life-threatening situations. Doctors may use a catheter inserted into a vein in the groin or arm and threaded to the clot in the lung. They use the catheter to remove the clot or deliver medicine to dissolve it. Rarely, surgery may be needed to remove the blood clot.
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