Pulmonary embolism (PE) is a serious and potentially life-threatening condition. PE is considered a medical emergency and requires immediate treatment to prevent further complications.
Pulmonary embolism or lung embolism is caused by blood clots blocking lung arteries, typically originating from deep vein thrombosis (DVT) in the legs.
This blockage prevents oxygenated blood flow from reaching vital organs, potentially leading to hypoxemia, right heart failure, pulmonary infarction, or other complications.
Chronic thromboembolic pulmonary hypertension can result from unresolved PE, and there is a significant risk of recurrence, highlighting the importance of anticoagulant (blood thinner) therapy.
● Shortness of Breath: This is typically the most common symptom of PE. It can occur suddenly and worsen with exertion.
● Chest Pain: The pain may feel like a sharp, stabbing sensation that worsens with deep breaths (pleuritic pain) or a persistent, aching discomfort.
● Rapid Heartbeat: Also known as tachycardia, fast or irregular heartbeat may be one of the body’s responses to reduced oxygen levels.
● Coughing: Some individuals with PE may experience coughing, sometimes producing blood-streaked sputum (hemoptysis).
● Leg Swelling: A sign of deep vein thrombosis (DVT), leg swelling, or pain, especially in the calf, could indicate the presence of a blood clot that has the potential to travel to the lungs.
● Flu-like Symptoms: Some people may exhibit symptoms that resemble a respiratory infection or flu, such as mild fever, chills, or general fatigue, which can delay a correct diagnosis.
Pulmonary embolism (PE) can be triggered by various health and lifestyle factors that increase the likelihood of blood clot formation and subsequent travel to the lungs.
● Age: The risk of PE increases with age, particularly for individuals over 60. Ageing affects the cardiovascular system, making older adults more susceptible to blood clots.
● Family History: A family history of PE or venous thromboembolism (VTE) can elevate one's risk. Genetic factors might contribute to a predisposition for clotting.
● Recent Surgery: Major surgeries, especially those involving the pelvis, hips, or legs, can increase clotting risks due to immobility and the potential for venous injury.
● Cancer: Certain cancers, such as lung or pancreatic cancer, and cancer treatments, like chemotherapy, can elevate the risk of developing blood clots.
● Heart Disease: Conditions like heart failure or arrhythmias can contribute to blood stasis and increase PE risk.
● Clotting Disorders: Inherited conditions like Factor V Leiden or antiphospholipid syndrome increase the likelihood of abnormal clot formation.
● Sedentary Lifestyle: Prolonged inactivity, such as long periods of sitting or bed rest, can lead to blood stasis in the legs, promoting clot formation.
● Smoking: Smoking damages blood vessels and increases the risk of clot formation and cardiovascular diseases.
● Obesity: Excess weight strains the veins, particularly in the legs, increasing the risk of clots.
● Certain Medications: Hormonal medications, including birth control pills and hormone replacement therapy, can elevate the risk of clotting due to changes in blood composition.
● Long Haul Air Travel: Due to dehydration and prolonged sitting during flight will lead to increased blood concentration and blood stasis in the legs.
● Pregnancy: Pregnancy increases the risk of clotting due to hormonal changes, increased pressure on pelvic veins, and reduced mobility, especially during the third and post-partum periods.
● Recent Trauma: Significant injuries, particularly to the legs or pelvis, can lead to clot formation due to vascular damage and immobility.
● Certain Medical Treatments: Treatments like chemotherapy, prolonged intravenous catheters, or central venous lines can increase clotting risks due to direct venous irritation or underlying health conditions.
The treatment for pulmonary embolism (PE) typically includes medication and, in some cases, surgical or non-surgical procedures, depending on the severity of the condition.
● Anticoagulants are the first-line treatment for PE, are also known as blood thinners. Anticoagulants help prevent new clots from forming and stop existing clots from growing. They do not dissolve the clots already present but allow the body to break them down gradually. Common anticoagulants include heparin, warfarin, and newer direct oral anticoagulants (DOACs) such as dabigatran, rivaroxaban and apixaban and edoxaban. Treatment usually begins with heparin or a DOAC, which acts quickly, followed by long-term anticoagulation therapy.
● Thrombolytics: In severe cases of PE, where the blood clot is life-threatening or causing significant hemodynamic instability, thrombolytic medications might be used. These drugs, often called "clot busters," help dissolve clots quickly. Thrombolytics like alteplase or tenecteplase are typically reserved for situations where the potential benefits of rapid clot resolution outweigh the risk of major bleeding.
● Embolectomy: This surgical procedure is performed to remove clots in the pulmonary arteries. Embolectomy is usually considered when a patient is critically ill and thrombolytic therapy is contraindicated or has not been effective. The procedure can be done through open surgery or via a less invasive catheter-based technique, depending on the patient's condition and the clot's location.
● Inferior Vena Cava (IVC) Filters: An IVC filter may be used when patients cannot take anticoagulants or have recurrent pulmonary embolism despite being on blood thinners. This small device is inserted into the inferior vena cava, the large vein that carries blood from the lower body to the heart. The filter catches and traps clots before they can travel to the lungs, thereby preventing PE. It's a preventive measure that can reduce the risk of future pulmonary embolisms, though it does not treat existing clots.
Pulmonary embolism (PE) is a serious condition that requires prompt attention. Recognising symptoms like shortness of breath and rapid heartbeat is crucial for timely intervention.
At Prince Court Medical Centre's Cardiology Department, our services include advanced diagnostics, innovative treatments, and personalised rehabilitation programs.
We are committed to supporting your heart health journey for a healthier future. Contact us to schedule a consultation and take charge of your cardiac wellness.
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