Annual EKG Screening for Heart Disease
What To Know About Pulmonary Embolism?
A pulmonary embolism is a blockage in the pulmonary artery that supplies blood to the lungs. The blockage, usually caused by a blood clot, impairs oxygenation of the blood and can damage the heart. This means it can be life threatening.
The word "embolism" comes from the Greek émbolos, meaning "stopper" or "plug."
In a pulmonary embolism, the embolus forms in one part of the body and circulates throughout the blood supply. It then blocks the blood flowing through a vessel in another part of the body, namely the lungs. Blood clots often develop in the leg, which is called deep vein thrombosis (DVT).
This article lists the symptoms of pulmonary embolism and outlines its diagnosis and treatment options.
Although the exact number of those affected by pulmonary embolism or DVT is unknown, it may affect as many as 900,000 people in the United States each year.
The National Heart, Lung, and Blood Institute notes that a person may not experience any symptoms of a pulmonary embolism. Others may experience symptoms that develop within seconds to minutes or over days to weeks. The symptoms can also start mild and become more severe.
Common symptoms include:
Less common symptoms include:
Severe symptoms call for immediate emergency medical assistance. More severe cases may result in shock, loss of consciousness, cardiac arrest, and death.
Treatments for a pulmonary embolism aim to:
The main treatment option for pulmonary embolism is anticoagulation.
A doctor will prescribe anticoagulants or blood-thinning medications, such as warfarin, heparin, or direct oral anticoagulants, to stop blood clots from getting bigger and prevent new clots from forming.
They may administer an anticoagulant as soon as they suspect a pulmonary embolism before they have made a definitive diagnosis.
A person will then need to take anticoagulants for approximately 3 months or longer.
For large blood clots causing severe symptoms or complications, a doctor may prescribe an intravenous thrombolytic. However, these carry a high risk of excessive bleeding. Thrombolytics include Activase, Retavase, and Eminase.
In emergencies, a person may require surgery, such as catheter-assisted blood clot removal. A catheter-assisted blood clot removal requires a surgeon inserting a flexible tube to reach the blood clot in the lung. They can then insert a tool to break up the clot or administer medication.
A pulmonary embolism occurs when an embolus, usually a blood clot, blocks the blood flowing through an artery that feeds the lungs.
A blood clot may start in an arm or leg, known as deep vein thrombosis (DVT).
After that, it breaks free and travels through the circulatory system toward the lungs. When the embolus is too large to pass through the small vessels, it forms a blockage.
This blockage stops blood from flowing into a part of the lung. This causes the affected section of the lung to die through lack of oxygen. The blood clot can also cause pressure to build in the right side of the heart, eventually causing heart failure.
Rarely, a pulmonary embolism can result from an embolus that is formed from fat droplets, amniotic fluid, or some other particle that enters the bloodstream.
The risk factors for developing a pulmonary embolism can be genetic or acquired.
Some acquired risk factors include:
To reduce the risk of developing a blood clot or pulmonary embolism, a person can:
A person undergoing surgery should discuss a plan to prevent blood clots with a healthcare professional. They will also advise on how to prevent blood clots during the recovery period.
Those with a high risk of developing pulmonary embolism may require anticoagulant medications.
To reach a diagnosis, the doctor will look at the person's history and consider whether they are likely to have an embolism. They will carry out a physical examination. Doctors may find it challenging to make a diagnosis because other conditions have similar symptoms.
The doctor may perform the following tests:
A doctor may also perform other imaging tests so they can look at the veins and the function of the heart and lungs.
With effective and timely treatment, most people who experience a pulmonary embolism can make a full recovery. However, the condition can carry a high risk of fatality without timely intervention.
A person's outlook can also be affected depending on the underlying condition that caused the blood clot or pulmonary embolism.
A pulmonary embolism is a blockage in the pulmonary artery. The pulmonary artery supplies blood to the lungs. The blockage, which usually occurs due to a blood clot, prevents the oxygen from reaching the lungs.
Anyone experiencing symptoms of a pulmonary embolism should seek urgent medical help. This is because timely treatment and diagnosis can improve a person's outlook. Common symptoms include shortness of breath, rapid breathing, high heart rate, and pain when breathing deeply.
Treatment often involves anticoagulant medications. In severe cases, surgery may be necessary.
Structure Of The Cardiovascular System
If you clench your hand into a fist, this is approximately the same size as your heart. It is located in the middle of the chest and slightly towards the left.
The heart is a large muscular pump and is divided into two halves - the right-hand side and the left-hand side.
The right-hand side of the heart is responsible for pumping deoxygenated blood to the lungs.
The left-hand side pumps oxygenated blood around the body.
Each side of the heart consists of an atrium and a ventricle which are two connected chambers.
The atria (plural of atrium) are where the blood collects when it enters the heart.
The ventricles pump the blood out of the heart to the lungs or around the body.
The septum separates the right-hand and left-hand side of the heart.
The tricuspid valve is located between the right atrium and right ventricle and opens due to a build-up of pressure in the right atrium.
The bicuspid valve is located between the left atrium and left ventricle and likewise opens due to a build-up of pressure, this time in the left atrium.
The semilunar valves stop the back flow of blood into the heart. There is a semilunar valve where the aorta leaves the left ventricle and another where the pulmonary artery leaves the right ventricle.
There are four main blood vessels that take blood into and out of the heart.
The aorta is the largest artery in the body. It carries oxygenated blood away from the left ventricle to the body.
The vena cava is the largest vein in the body. It carries deoxygenated blood from the body back to the heart.
The pulmonary artery carries deoxygenated blood away from the right ventricle to the lungs.
The pulmonary vein returns oxygenated blood from the lungs to the heart.
Arteries carry oxygenated blood away from the heart (except for the pulmonary artery which carries deoxygenated blood away from the right ventricle to the lungs).
The main artery is the aorta.
The main vein is the vena cava.
Why You Should Consider Pulmonary Rehab
Pulmonary rehab is the best kept secret of pulmonary medicine. Or at least that is what Connie Paladenech, the Manager at Atrium Health Wake Forest Baptist Cardiac and Pulmonary Rehabilitation Center and a member of the Board of Directors at the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) believes. That is because, though it is known to improve the lives of people living with a chronic lung disease like chronic obstructive pulmonary disease (COPD), only about 3% of eligible patients are using this great program. Connie answered some of our questions about pulmonary rehab and shared her insight into why you or your loved one may want to consider a pulmonary rehabilitation program.
Q: What exactly is pulmonary rehab?A: Pulmonary rehab is a proven component of medical care for people with long-term lung diseases, such as COPD or pulmonary fibrosis. We know that pulmonary rehab provides improvement in breathing-related symptoms, increases your ability to exercise and improves your overall quality of life. It achieves these goals without medications or requiring the patient to undergo surgeries.
We can't regrow lung tissue without a lung transplant, so some of the breathing tests may not show large measurable changes, but anyone who has worked in the field as long as I have knows the tremendous improvements our patients experience. This is because pulmonary rehab is a comprehensive program that involves many different experts like respiratory therapists, physical therapists, and doctors working together to help you manage a lifelong lung disease. Meaning it also treats the many comorbidities like anxiety or depression that patients experience when they have a chronic lung disease.
Q: How does someone get started with pulmonary rehab?A: The first step is for a patient to talk to their healthcare provider to see if pulmonary rehab is a right fit for their treatment plan. Pulmonary rehab is a medically supervised program, so for patient safety and insurance purposes, a physician's prescription is needed. Once physician approval is received, the journey begins with a thorough assessment either one-on-one or in a group setting. Then the staff and the patient will work together to develop an individually structured plan, which is designed to improve both patients' physical and psychological condition.
There are several therapies that might be included such as exercise training, education to help with more successful self-management and behavior changes. This may include education on medication, breathing and inhaler techniques, energy conservation techniques, self-management skills and even dealing with stress. Another important part of a pulmonary rehab program is socialization and being around other people living with a lung disease.
Besides exercise training, pulmonary rehab also focuses on improving emotional health. In fact, stress is a big problem, so we spend a lot of time helping patients recognize triggers and learn relaxation and coping techniques. Nutrition is another important aspect as many patients are either under or overweight, so we need to help give them the tools necessary to get the adequate nutrition they need to enable them to have the energy to do their daily activities.
In the over 50 years I have been involved with pulmonary rehab, there have been incredible changes. Treatments are now really tailored to the individual. So, patients will want to determine what specific improvements could make their day-to-day lives easier. For instance, maybe they want to be less short of breath while performing a specific activity like climbing the stairs. Or maybe they just want to have more energy throughout the day. By monitoring oxygen levels during rehab, we are able to make sure they are getting the right amount of oxygen, and if they require supplemental oxygen, we assess whether or not they have the right device or dosage and help correct any discrepancies.
And though the programs have a specific length, we focus on creating lifelong management plans that can help patients continue to live their best lives well after graduating from their program.
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