Pulmonary emobolism

Pulmonary-embolism

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Respiratory system - Pulmonary embolism 5 -- Smart-Servier

Pulmonary embolism

3D Medical Animation still shot Pulmonary Embolism

Pulmonary embolism (PE) is a medical condition wherein a blood clot forms in the arteries of the lungs, potentially leading to serious complications or death if left untreated. Most often, these blood clots originate in the deep veins of the legs, a condition referred to as deep vein thrombosis (DVT). From there, they travel to the lungs.

Etiology

PE mainly occurs when a blood clot breaks free from its original site, usually the deep veins of the legs, and travels through the bloodstream, ultimately lodging in the pulmonary arteries. The main risk factors include:

• Prolonged immobility, such as after surgery or during long flights
• Genetic predisposition
• Trauma or injury, especially to the legs
• Certain medical conditions like cancer or heart diseases
• Oral contraceptive pills or hormone replacement therapy
• Pregnancy
• Smoking

Symptoms

The symptoms of PE can vary greatly, depending on the size of the clot, the extent of lung involvement, and the presence of underlying medical conditions. Common symptoms include:

• Shortness of breath
• Chest pain that may become worse upon breathing deeply, coughing, or even eating
• Rapid heart rate
• Unexplained cough, sometimes with bloody mucus
• Excessive sweating
• Feeling lightheaded or dizzy

Diagnosis

If a PE is suspected based on a patient's clinical presentation, various diagnostic tests may be employed:

• D-dimer test: A blood test that measures clot-dissolving substances
• Computed tomography (CT) scan
• Pulmonary angiography
• Ultrasound of the legs to check for DVT
• Electrocardiogram (ECG)

Treatment

PE is a serious condition that requires prompt medical treatment:

Anticoagulants: Also known as blood thinners, these drugs prevent new clots from forming. Examples include heparin, warfarin, and newer anticoagulants like dabigatran.

• Thrombolytics: These are clot-dissolving drugs and are reserved for life-threatening situations.
• Vena cava filters: In cases where the patient cannot take anticoagulants, a filter can be placed in the vena cava (the main vein leading to the heart) to trap clots before they reach the lungs.
• Surgery or catheter removal: This method is reserved for massive PEs where there is hemodynamic instability.

Prognosis

The prognosis of PE largely depends on the size and location of the clot, the amount of lung affected, and the immediate treatment rendered. If treated promptly, many patients can recover fully. However, if left untreated, PE can be fatal, emphasizing the importance of early detection and intervention.

Prevention

Steps to reduce the risk of developing PE include:

• Frequent movement during long trips to prevent DVT
• Compression stockings for those at risk
• Early mobilization after surgery
• Taking anticoagulants as prescribed for those at heightened risk

See Also

• Deep vein thrombosis
• Coagulation disorders
• Anticoagulant therapy

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