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Everything You Need to Know About Pulmonary Embolism: Causes, Symptoms, and Treatment

Pulmonary embolism (PE) is a severe medical condition when a blood clot blocks one or more lung arteries. It can cause permanent damage to the lungs and other organs due to restricted blood flow and can be life-threatening if not treated promptly. Understanding the causes, symptoms, and treatments for pulmonary embolism is crucial for prompt diagnosis and effective management. This article delves into what you need to know about this critical condition. 

Causes of Pulmonary Embolism 

Most often, pulmonary embolism is caused by deep vein thrombosis (DVT), a condition where blood clots form in the deep veins of the body, typically the legs. These clots can break loose and travel through the venous bloodstream to the heart then lodge in the pulmonary arterial tree, causing blockage. Factors that can increase the risk of developing DVT and subsequent PE include prolonged immobility, certain medical conditions, surgery, trauma, and certain genetic predispositions. Aside from blood, air, amniotic fluid, fat or tumor cells can enter the pulmonary vasculature and cause pulmonary embolism. 

What Does Pulmonary Embolism Feel Like?    

A pulmonary embolism can manifest with a variety of symptoms, and the experience can be pretty alarming. Individuals often report a sudden onset of symptoms that can rapidly intensify. Describing the sensation of a pulmonary embolism can help potential patients and their loved ones recognize when immediate medical attention is needed. 

When a blood clot travels to the lungs and creates a blockage, the body's response can lead to a range of physical sensations or symptoms of pulmonary embolism: 

  • Chest Pain: One of the most common and notable feelings is a sharp, stabbing chest pain that may worsen with deep breaths, coughing, or even when bending over or eating. This pain is often confused with a heart attack, as it can be quite severe and frightening. 
  • Shortness of Breath: This can occur suddenly and without warning. It may feel like you've just run a sprint even though you haven't moved, or like you can't catch your breath no matter how deeply you try to inhale. 
  • Rapid Heartbeat: You may notice palpitations, your heart pounding or racing, a sensation known as tachycardia. This is your heart's response to the lack of oxygenated blood in the tissues and the increased workload  due to  the blockage. 
  • Unexplained Cough: A dry cough or coughing up blood or blood-streaked sputum, medically termed as hemoptysis, can sometimes occur. This results from lung irritation and may be one of the more alarming signs of PE. 
  • Anxiety or a Sense of Dread: Many patients describe a sudden feeling of anxiety, fear, or an impending sense of doom. These feelings are not just emotional responses but may be related to the body's reaction to reduced oxygen levels and the strain being placed on the heart and lungs. 
  • Dizziness or Lightheadedness: As the oxygen supply to the brain decreases, you may feel dizzy or lightheaded, and in severe cases, this can lead to fainting. 
  • Other Symptoms: Additional symptoms can include sweating, fever, or a bluish tint to the skin, particularly around the lips and nails, known as cyanosis. These symptoms indicate that the body is struggling to maintain adequate oxygen levels. 

What Is the Earliest Sign of Pulmonary Embolism?  

The earliest signs of a pulmonary embolism can be sudden shortness of breath (tachypnea), difficulty of breathing (dyspnea) or chest pain (angina) in 55-80% of cases. However, it may also present as a sense of unexplained apprehension, anxiety, or a feeling of dizziness or fainting. It’s important to note that some individuals may not exhibit noticeable symptoms until the condition is advanced. 

Symptoms of Deep Venous Thrombosis    

As deep venous thrombosis (DVT) is the most common cause of pulmonary embolism (PE), the following signs and symptoms may also be investigated: 

  • Swelling in the leg or along a vein in the leg 
  • Pain or tenderness in the leg, when standing or walking or even stationary 
  • Increased warmth in the area of the leg that's swollen or painful 
  • Red or discoloured skin on the affected leg 
  • Also, notable in a patient’s history would be prolonged periods of immobilization, especially in patients who underwent major surgery or trauma or have hypercoagulable states such as obesity, malignancy, pregnancy and disorders of blood coagulation. 

How Is Pulmonary Embolism Diagnosed? 

To diagnose a pulmonary embolism, healthcare providers will evaluate your symptoms, medical history, and risk factors. They may perform several tests, including:  

  • Blood tests to check for clot-dissolving substances (D-dimers/fibrin split products, BNP, troponin) or other indicators of PE.  
  • 12-lead ECG to check for irregular rhythms that can predispose to PE such as atrial fibrillation 
  • Chest X-ray to check for lung problems that could explain your symptoms.  
  • CT pulmonary angiography provides detailed images of the blood vessels in your lungs, currently the diagnostic modality of choice for patient suspected of PE. 
  • A ventilation-perfusion scan (V/Q scan) to detect abnormalities in airflow and blood flow in the lungs. 
  • Ultrasound of the legs to look for signs of deep vein thrombosis. 

Pulmonary Embolism Treatment    

Treatment for pulmonary embolism seeks to prevent further clotting and dissolve existing clots. It can include: 

  • Anticoagulant medications, also known as blood thinners, which prevent new clots from forming. 
  • Thrombolytic therapy involves drugs to dissolve clots. 
  • In severe cases, surgery or minimally invasive procedures may be necessary to remove the clot or to install a filter in the vena cava to prevent future clots from reaching the lungs, especially in patients with contraindications to anticoagulant or thrombolytic therapy. 

A pulmonary embolism is a potentially life-threatening condition that requires immediate medical attention. Knowing the signs and symptoms can lead to prompt treatment, which is critical for a good outcome. If you experience any symptoms of PE or have risk factors for blood clots, seek medical advice immediately. With timely and appropriate care, the risks can be reduced.    

Remember, health is a journey, not a destination. Stay informed and proactive in your health care, and don’t hesitate to consult with healthcare professionals whenever concerns arise. Your awareness and actions can make a difference in preventing and treating pulmonary embolism. 

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Topics: General Practice / Family Medicine

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OT&P Healthcare

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