Pulmonary embolism

What is a pulmonary embolism?

A pulmonary embolism is the name given to a blood clot that lodges in one of the blood vessel that supplies the lungs with blood. It is a very serious condition, one that can cause death within hours if not medically treated.

How does a pulmonary embolism occur?

Blood clots can form in various veins throughout the body. Sometimes such a clot, known as an embolus, can detach itself and flow with the blood around the body. In the vast majority of cases, the clot comes from a vein in the legs and came about as a result of deep vein thrombosis (DVT). Occasionally, the embolus is not a blood clot at all, but an air bubble, globule of fat, or tissue detached from a tumour.

If the embolus becomes lodged in one of the pulmonary arteries that supply the lungs, it can seriously affect the flow of oxygen and blood through the body. The condition can onset rapidly, does not always exhibit any symptoms, and can be fatal in one in 10 cases.

What increases the chances of having a pulmonary embolism?

In most cases, people who have a pulmonary embolism are already suffering from another complaint, usually a heart condition or deep vein thrombosis. Some people are more at risk than others, however, and they include:

  • Older people, especially those who are bedridden
  • People who have or have had cancer.
  • Anyone who has recently undergone surgery, especially in the abdomen.
  • Anyone who has a relative who has suffered a pulmonary embolism. There seems to be a greater risk for family members of those who have already had one.
  • Overweight people have a slightly greater chance of suffering an embolism.
  • People who have recently suffered a fracture of the pelvis or legs.
  • Pregnant women and women who have recently given birth

What are the symptoms of a pulmonary embolism?

Sometimes there are no symptoms at all. However, many people who experience a pulmonary embolism will feel some or all of the following symptoms:

  • Sudden inexplicable breathlessness
  • Sudden, sharp chest pain
  • Coughing up blood mixed with phlegm
  • An uncomfortable, nervous or anxious feeling
  • Exhaustion and a mild fever for a number of days following.

In nearly every case of embolism, hospital treatment is essential because of the possibility of a greater embolus occurring subsequently. When one of these larger emboli become lodged in the lung, urgent life-saving medical attention will be required. The symptoms of a severe pulmonary embolism include:

  • Rapid onset of pain
  • Becoming pale, and experiencing cold, sweaty flushes
  • Falling unconscious

It is very difficult to revive someone in this condition without medical attention. They need to be transferred to hospital immediately.

How can a pulmonary embolism be treated?

Unfortunately, a pulmonary embolism can be difficult to diagnose, as it may not display symptoms. When it does exhibit symptoms, they can be easily mistaken for other complaints, such as a cardiac arrest.

If a pulmonary embolism is diagnosed, the key issue is to stabilise the patient’s cardiovascular system until the embolus can be dissolved. This process can take up to a fortnight.

People with a diagnosed embolism receive anti-coagulant drugs to thin the blood and lessen the chance of another embolus developing. They may have to receive oxygen treatment also, as the lungs’ ability to function is impaired. Sometimes it is possible to dissolve the embolus; other times it is advisable to operate to remove it. Often, it is allowed to resolve itself under medical supervision.

People who have had an embolism in the past may find that they must take anti-coagulant for some time, possibly even the rest of their lives, to avoid another embolus developing.

If you feel any of the symptoms of a pulmonary embolism, especially if the symptoms develop very quickly, you must get to hospital immediately.

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