A pulmonary embolism (PE) occurs when a blood clot gets stuck in one of the arteries leading from the heart to the lungs because the clot blocks the normal flow of blood.
Blood goes from the heart to the lungs through the pulmonary artery. The blood is oxygenated in the lungs and then returned to the heart, which pumps oxygen-rich blood to the rest of your body. However, in pulmonary embolism, this mechanism is disturbed.
This blockage can cause serious problems, such as lung damage and reduced blood oxygen levels. A lack of oxygen can also damage other parts of your body. A pulmonary embolism can be fatal if the clot is large or smaller clots block the artery.
Pulmonary emboli usually travel from the deep veins of the legs to the lungs. Doctors call this event deep vein thrombosis (DVT). These clots form when blood cannot flow freely through the legs. Because your body has been immobile for a long time, for example, during a flight or a long drive, this also happens if you are on bed rest after surgery or illness.
Risk factors are the same as for DVT. Doctors refer to these cases as Virchow’s triad. They include the following:
This complication occurs if you are in the hospital or on bed rest for a long time. Pulmonary embolism can also occur while flying or driving a vehicle for a long time.
Doctors call this increased blood clotting, which can be caused by medications such as birth control pills. Smoking, cancer, recent surgery, or pregnancy can also put you at risk.
Injury to the leg can lead to this complication.
In rare cases, a pulmonary artery may be blocked by something other than a clot, such as an air bubble or part of a tumor. If a large bone is broken, bone marrow fat sometimes enters the bloodstream and blocks the vessel.
The best way to prevent PE or pulmonary embolism is to prevent blood clots from forming deep in your veins. This can be challenging if you have spent much time resting after surgery or illness or had a long flight.
If you are at risk, here are a few things that may help you reduce your chances of developing a dangerous blood clot:
Doctors call them anticoagulants. These factors prevent the formation of clots in the blood. Your doctor may prescribe them while you are in the hospital for surgery. You may also be advised to take these medicines after being discharged home.
If you have been hospitalized after a stroke or heart attack, or if you are suffering from complications from cancer, your doctor may also prescribe blood thinners.
There are long socks that put pressure on your legs. This extra pressure helps move blood through the veins and muscles of the leg. Your doctor may recommend wearing these socks for a while after surgery.
After an extended hospital stay or an illness that has kept you in bed for a long time, get out and take a walk. This will keep the blood flowing in your legs and not have a chance to pool.
If you have a long flight, try to walk every few hours. If you cannot stand, bend your toes by pulling your toes towards you. Here are a few more stretches you can do while sitting:
With one hand, pull your leg up to your chest.
Hold the lower part of one leg with the other hand.
Hold this position for 15 seconds, then try it with the other leg. Do this up to 10 times per hour.
If you are driving a long distance, stop every hour and stretch your legs.
Be sure to drink extra fluids to keep your body hydrated.
Other actions you can take include:
When a blood clot blocks a blood vessel in your lung, you have a pulmonary embolism (PE). The symptoms of this condition may vary. The symptoms you experience depend on the size of the clot and the extent of your lung involvement. If you have lung or heart disease, this can also play an important role.
PE symptoms appear suddenly:
When a clot forms in a deep vein of the legs, it is called a deep vein thrombosis (DVT). If the clot breaks off and travels to your lung, it becomes a PE.
See a doctor immediately if you notice symptoms of DVT. If detected early, doctors can prevent pulmonary embolism. Symptoms of DVT include:
The doctor will likely start with a physical exam. He will carefully look at your feet to see if he notices any symptoms such as swelling, tenderness, discoloration, or heat. These signs may indicate that one of your deep veins is clotted.
Next, your doctor may order several tests, such as a chest X-ray or ultrasound. A blood test may also be required. These tests can measure the amount of oxygen and carbon dioxide in the blood. They also help the doctor detect a substance called D-dimer, a small protein fragment that appears in the blood after the body breaks down the clot.
Other tests your doctor may order include:
This test is a particular type of X-ray test. It is also the primary test doctors use to see if you have PE. Your doctor will inject dye or contrast into the veins. The doctor will then be able to see the blood vessels in the lungs with an X-ray.
This test is used if CTPA is unavailable or unsuitable for you. This method uses radioactive material to show which parts of the lungs have airflow (ventilation) and blood flow (perfusion). A clot may be present if blood flow is low in a particular area, but airflow is normal.
This is the most accurate test to diagnose PE. This test is used if other tests do not show precise results. The specialist inserts a thin tube (catheter) into the large vein in the groin and the veins inside the lung. Then he injects the dye through the catheter. X-ray images of the blood vessels inside the lungs appear. This test is rarely used due to the presence of CTPA.
If you are pregnant or your doctor is concerned that other tests that use contrast could harm you, this method can be a good option.
This is a heart ultrasound test. It cannot detect PE but shows whether the heart is strained.
A blood clot in the lung is called a pulmonary embolism (PE). This complication is severe and can threaten a person’s life. However, the good news is that doctors can treat it if it is caught early.
Here we look at some of the most common ways to deal with this disease.
1) Blood thinners
These drugs, also called “anticoagulants,” are the most common method of treating lung blood clots. They play two leading roles:
These drugs do not destroy blood clots. Instead, your body does this naturally and over time.
The most common blood thinners are warfarin and heparin. Warfarin is a pill that can treat and prevent clots. You can also receive these drugs by injection or IV. Many blood thinners are available in pill form, and your doctor will help you decide which one will work best for you. Heparin can reduce the chance of more clots forming. You can also get it by injection or IV.
Treatment may begin in the hospital or the ER, and you can be discharged the same day. The duration of hospitalization and treatment depends on your condition.
Low molecular weight heparins are also widely used. These drugs can also be injected at home. They are:
The main complication of blood thinners is internal bleeding. If the drug thins your blood too much, internal bleeding may occur. Your doctor may order a blood test to monitor this. However, even at therapeutic doses, internal bleeding is dangerous.
In life-threatening situations, doctors may use thrombolytic drugs. These drugs quickly break up the clots that cause severe symptoms. However, they can lead to sudden bleeding and should be used only after careful consideration.
In cases that have been carefully investigated, this method is another emergency treatment that the doctor may use. He inserts a thin and flexible tube into a vein in the thigh or arm. This tube is inserted into your lung, where it removes the clot or uses medicine to remove it.
3) Other treatment methods
If you cannot take blood thinners, your doctor may use these options to treat your PE:
The inferior vena cava is a large vein that carries blood from the lower parts of the body to the heart. The doctor can place a filter in this vein to stop the clots before they reach the lungs. This filter does not prevent the formation of clots but only prevents them from reaching the lungs.
Sometimes called “support tubes,” these stockings come up to your knees and apply pressure to your legs to prevent blood pooling or clotting. (Most clots that form in the lung start from the leg area).
Rarely, surgery may be needed to remove a pulmonary clot.
Pulmonary embolism is the blockage of one or more arteries that cause blood to reach the lungs. Most often, the cause of blockages in the arteries is blood clots in other parts of the body and eventually reaching the lungs. Sometimes the cause of this blockage may be the presence of glands, air bubbles, or fat in other body parts.
If a blood clot forms or gets stuck in the artery, lung congestion occurs and prevents blood and oxygen from reaching other organs, which causes lung tissue damage and cell and organ death.
Also, the presence of blocked arteries causes shortness of breath and difficulty breathing and eventually causes death.
Dr. Majid Zohrabi started treating his patients in Dubai in 2022 and continues his activities in private medical centers in the UAE.