Pulmonary Embolism

Pulmonary embolism (PE) is a condition that occurs when a blood clot blocks one or more of the arteries in the lungs. This can cause serious problems, including chest pain, shortness of breath, and even death.

Early diagnosis and timely treatment are critical for the best possible health outcome.

If a patient experiences shortness of breath, chest pain, or coughing up blood, they may be experiencing pulmonary embolism symptoms. These symptoms, in particular, could be life-threatening and require immediate medical intervention.

Other symptoms may include:

• Dizziness or lightheadedness
• Irregular or rapid heartbeat
• Excessive sweating
• Discoloured or clammy skin (cyanosis)
• Fever
• A feeling of anxiety
• Low blood pressure

Pulmonary embolism is often caused due to deep vein thrombosis (DVT) or blood clots in the legs. Therefore, patients may experience DVT symptoms such as:

• Pain in the affected leg
• Swelling in the leg
• Redness, tenderness, or soreness in the leg
• Discoloured skin
• Wheezing

The classification of pulmonary embolism is based on how long the patient has been experiencing the symptoms.

Listed below are the three pulmonary embolism types:

1. Acute: This type of pulmonary embolism occurs when a blood clot blocks one or more arteries in the lungs. This can cause severe shortness of breath and chest pain. It can be fatal if not treated quickly.
2. Subacute: Pulmonary embolism that develops over 2-12 weeks is called subacute PE. It is characterised by a high mortality rate and symptoms such as shortness of breath. Subacute PE usually requires aggressive treatment options to break up the blood clot.
3. Chronic: This type of PE is caused by residual blood clots in the arteries of the lungs despite treatment. However, a very small percentage of patients experience chronic PE. It may require surgical treatments such as pulmonary angioplasty to remove scar tissue and blood clots completely.

Besides DVT, there are other probable pulmonary embolism causes, including:

• Genetic predisposition to blood clot formation
• Previous history of clots
• Injury to the legs
• Surgery of the legs
• Cancer therapy
• Obesity
• Certain medications, such as oestrogen replacement therapy and birth control pills
• Variose veins (enlarged veins of the legs)
• Caesarean delivery
• Certain medical conditions, including inflammatory bowel disease, stroke, high blood pressure, chronic obstructive pulmonary disease (copd), and heart failure
• Cigarette smoking
• Prolonged immobility due to bed rest or long hours of travel

Pulmonary embolism diagnosis can be determined through a variety of tests, including a CT (computed tomography) scan or an MRI (magnetic resonance imaging).

Apart from that, our doctors conduct a thorough physical exam and evaluate the patient’s medical history and blood work to diagnose pulmonary embolism.

Chest X-rays can reveal the anatomic location, shape, contour, and size of the lungs, heart, and pulmonary arteries that may reveal clotting.

Other pulmonary embolism diagnosis methods include:

1. Ventilation-perfusion scan (V/Q scan): The test is performed by injecting a radioactive substance into the vein and measuring its uptake in the lungs. A VQ scan is used to assess blood flow and air exchange in the lungs.
2. Pulmonary angiogram: It is a diagnostic procedure used to visualise the blood vessels in the lungs. The test is performed by injecting a contrast dye into the pulmonary artery and then taking X-rays of the lungs.
3. Duplex ultrasound: It is a painless, noninvasive exam that uses sound waves to visualise blood flow in the arteries and veins of the legs. This test can be used to diagnose problems with the blood vessels, such as blockages or clots (that often travel into the lung).

Treatment typically involves anticoagulant medication to prevent further clotting, as well as measures to remove the clot.

The pulmonary embolism treatment options include:

• Fibrinolytic therapy: This treatment option involves giving medicines intravenously to break down the clot. However, this method is only administered in life-threatening situations.
• Vena cava filter: It is a small, metal device that is placed in the vena cava, the large vein that carries blood from the lower body to the heart. The filter catches blood clots before they can travel to the heart and lungs, where they can cause serious problems. We recommend a vena cava filter if anticoagulation medicines cause bleeding or when patients can’t receive any other treatment due to their medical conditions.
• Pulmonary embolectomy: This surgical procedure is used to remove a blood clot from the lungs. It is performed when patients don’t respond well to medications or therapy or are under serious medical duress.
• Percutaneous thrombectomy: It is a minimally invasive procedure used to remove a blood clot from a blood vessel. The procedure is performed by making a small incision in the skin and then using a catheter to remove the clot.

Life expectancy after pulmonary embolism diagnosis depends on various factors, such as the patient’s overall health, age, and type of embolism.

Most people do make a full recovery from PE, given that they see a doctor immediately upon noticing the signs and symptoms and follow their treatment plan.

But is it possible to prevent PE in the first place?

As it turns out, it is:

• Get regular exercise. Prolonged sitting or bed rest due to an illness can increase the risk of clot formation in the legs. Exercise keeps the blood flowing.
• Wear compression stockings after surgery to squeeze the legs. The pressure is good for proper blood flow.
• Stretch the arms and legs during long trips.
• Maintain a healthy weight.
• Before receiving estrogen replacement therapy or taking birth control pills, consult our doctors to understand the risk of blood clots.
• Quit smoking.
• Talk to our doctors if you have preexisting conditions such as heart failure, diabetes, autoimmune diseases, kidney disease, or a family/previous history of blood clots.
• Drink plenty of fluids to prevent dehydration which can contribute to clot formation.

Sometimes diseases when left undetected and untreated can start dictating our lives. Maintaining good health requires timely attention to any growing symptoms. Your body is always giving signs, it is your prerogative to read them or at least reach out to someone who can help us resolve it.

If you or someone you know has a pulmonary embolism, it’s important to seek medical help immediately. You can do so by either visiting the CK Birla Hospital or fixing an appointment with Dr. Kuldeep Grover. Using our state-of-the-art medical facilities, our experienced staff will provide accurate diagnosis and appropriate treatment plan that is specific to your condition.