Pulmonary embolism

Embolism. Obstruction caused by an embolus formed in one blood vessel , which prevents circulation in another smaller vessel .

Summary

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  • 1 Alternative names
  • 2 Lung
  • 3 Definition
  • 4 Causes
  • 5 Symptoms of pulmonary embolism
  • 6 Prevention
  • 7 Diagnostics
  • 8 Treatments
  • 9 Internal links
  • 10 Sources

Alternative names

  • Venous thromboembolism
  • Blood clot in the lungs
  • Pulmonary blood clot
  • Plunger
  • Tumor embolus
  • Pulmonary embolism

Lung

Breathing organ of man and vertebrates that live or may live out of water : it is spongy, soft, flexible, that compresses and dilates, and occupies a part of the thoracic cavity.

Definition

Pulmonary embolism is the result of a clot of blood that takes place in a vessel blood anywhere on the body (usually in the leg), moves to an artery of the lung and causes an occlusion (blockage) of the artery. In general, the unobstructed arteries can send enough blood to the affected area of ​​the lung to prevent tissue death . However, in case of blockage of the large blood vessels or when suffering from pre-existing lung disease , the volume of blood supplied may be insufficient to prevent tissue death.; It is the situation known as pulmonary infarction .

Causes

Blood clotting is a normal process of the body to prevent bleeding . The body produces blood clots and then destroys them. In certain circumstances, the body may be unable to clear a clot, and this causes a serious health disorder.

Abnormal coagulation in the veins is related to a combination of various problems such as slow blood flow through the veins , excessive increase in clot formation factors, and injury to the vessel wall .

Once a clot has formed in the deep veins of the leg ( deep vein thrombosis ), there is a chance that part of the clot will rupture and travel through the bloodstream to other parts of the body. It is the most common cause of pulmonary embolism.

Other common causes may be a fat plunger, an amniotic fluid plunger, and air bubbles . The clot may also arise at the end of an intravenous catheter, then rupture and transport to the lung .

Symptoms of pulmonary embolism

Small emboli may not cause symptoms, but most cause choking. This may be the only symptom, especially when the heart attack does not occur . Often, the breathing is very fast; anxiety and agitation can be pronounced, and the affected person may manifest the symptoms of an anxiety attack. Acute chest pain may appear , especially when the person is breathing deeply (pleuritic chest pain).

The first symptoms may also be dizziness, lightheadedness, or seizures.

People with occlusion of one or more of the large pulmonary vessels may have bluish-colored skin (cyanosis) and die suddenly.

The infarct pulmonary produce cough , sputum tinged with blood , chest pain sharp to breathing and fever .

In people with recurrent episodes of small pulmonary emboli, symptoms such as chronic choking, swelling of the ankles or legs, and weakness tend to develop progressively over weeks, months, or years.

Prevention

For patients in the postoperative period, especially if they are older, the use of elastic measures, exercise for the legs, leaving the bed and resuming activity as soon as possible is recommended, in order to reduce the risk of clot formation.

Heparin (an anticoagulant), subcutaneously, is the most widely used treatment after surgery to decrease the chances of clot formation in the calf veins . It can cause bleeding and delay healing, hence its administration is reserved for patients at high risk of developing clots and those with heart failure, shock or chronic lung disease.

Dextran, which is given intravenously, also helps prevent clots, but like heparin, it can cause bleeding.

Diagnostics

The doctor may suspect pulmonary embolism based on a person’s symptoms and predisposing factors. However, certain procedures are often needed to confirm the diagnosis.

Chest radiography may reveal slight disturbances in the structures of the blood vessels after embolism and some signs of pulmonary infarction.

An electrocardiogram can show abnormalities, but these are often transient and only support the possibility of pulmonary embolism.

The perfusion test (scan) involves injecting a radioactive substance into the vein that passes into the lungs, where the supply of blood to the lung is observed (perfusion).

A lung ventilation scan is another procedure in which the patient inhales a harmless gas that contains a trace of radioactive material that is evenly distributed throughout the small air sacs in the lungs (alveoli).

Pulmonary imaging is the most accurate method of diagnosing a pulmonary embolism, but it carries some risk and is more uncomfortable than other tests. It consists of injecting into the artery a contrast substance (visible on the radiograph) that flows to the arteries of the lung. Pulmonary embolism appears on the radiograph as an arterial obstruction. Supplementary tests may be done to find out the origin of the embolus.

The chances of dying from a pulmonary embolism depend on the size of the embolus, the size and number of the blocked pulmonary arteries, and the patient’s state of health. The risk is higher in people with severe heart or lung disorders. Generally, people with normal heart and lung function survive, unless the plunger obstructs half or more of the lung vessels. Severe pulmonary embolism causes death within one to two hours. Approximately 50 percent of people with untreated pulmonary embolism may have another in the future.

Treatments

Treatment of pulmonary embolism is started with the administration of oxygen and, if necessary, analgesics.

The use of anticoagulants (blood thinners), decrease the ability of the blood to clot . Examples of these drugs are acenocoumarol (Sintrom) and heparin.

There are two forms of treatment that can be helpful in people whose lives are at risk from pulmonary embolism: thrombotic therapy and surgery .

Antithrombotic therapy drugs are administered intravenously to break the clot. However, these drugs cannot be used in people who have undergone surgery in the previous 10 days, in pregnant women or in people who have suffered a recent stroke, or in those prone to excessive bleeding . When the emboli repeat or the anticoagulants cause significant bleeding, a small metal device can be placed as a filter in the vena cava (the largest blood vessel that returns blood from the body to the heart), to prevent the movement of clots to the lung. Clots generally originate in the legs or pelvis and this filter prevents them from reaching the pulmonary artery.

 

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