Pulmonary embolism is a life-threatening condition. It occurs when one of the pulmonary arteries in the lungs gets blocked. The blockage is mostly caused by deep vein thrombosis. This is where blood clots travel from the deep veins in the legs to the lungs. Although rare, a blood clot can also travel from other parts of your body. If a pulmonary embolism is not addressed fast, it can result in death. The best way to prevent the condition is to take measures to ensure that you don’t get blood clots in the legs. Most life-threatening cases involve many blood clots blocking the arteries. When that happens, blood doesn’t flow to the affected lung as it should. This results in tissue and cells damage and death or pulmonary infarction. A pulmonary embolism can also be due to;

• Air bubbles
• Fat deposits from bone marrow in case of a broken bone 
• A part of a tumor breaks off and travels to the lungs

Types of Pulmonary Embolism 

There are different kinds of pulmonary embolisms depending on the severity of the condition.

Massive Pulmonary Embolism

This is acute pulmonary embolism accompanied by obstructive shock. The obstruction is severe and affects more than 50% of the pulmonary artery. This results in severe cardiopulmonary failure due to overload of the right ventricle. About 50% of patients diagnosed with pulmonary embolism have a massive pulmonary embolism.

Submassive Pulmonary Embolism

This is acute pulmonary embolism but without systemic hypotension. Common symptoms include myocardial necrosis and right ventricle dysfunction. 

Low-risk pulmonary embolism

Patients who don’t have either massive or submassive PE have low-risk PE. Their risk of dying is thereby low.

Symptoms of Pulmonary Embolism

Symptoms of PE vary from one person to another. The most common symptoms include;

• Shortness of breath when at rest or when active
• Heart attack-like symptoms like sharp pain in the chest, neck, jaw, shoulders, and arms. 
• Cough that may have bloody sputum 
• Pale or bluish skin that may appear clammy
• Rapid breathing and heartbeat
• Irregular heartbeat
• Increased sweating 
• You may also feel light-headed, anxious and may pass out

Diagnosis of Pulmonary Embolism

Pulmonary embolism presents symptoms that are like those of other diseases and conditions. Diagnosis is thus difficult. The doctor will go through your medical history and conduct a physical exam. After that, they may order more tests. 

• Imaging tests: Imaging tests like X-rays, ultrasound, CT and MRI scans assess the condition of your heart, lungs, and arteries. A duplex ultrasound assesses the structure of the vessels in your legs plus blood flow. The doctor may also order a ventilation-perfusion scan or V/Q scan to check the condition of the lungs. The scan evaluates how air is moving in and out of the lungs. On the other hand, a perfusion scan checks the flow of blood in the lungs. Another test that you may get is a pulmonary angiogram. The scan assesses different conditions like blockages, aneurysms, and stenosis.
• Blood tests: Blood tests check for blood clots and genetic disorders that may result in a pulmonary embolism. 
• Electrocardiogram (EKG): An EKG test evaluates the electrical activity of the heart. The test checks for any abnormalities that may lead to a pulmonary embolism. 
• How to Treat Pulmonary Embolism
• When caught early, a pulmonary embolism is treatable. Treatment options include;
• Blood thinners: Blood thinners prevent blood clotting. They also help shrink blood clots and prevent others from forming. 
• Fibrinolytic therapy: Known as clot busters, these medications break down blood clots. Clot busters are only used in very severe cases of PE because they increase the risk of bleeding.
• Vena cava filter: This is a small metallic device placed in large vessels that take blood to the heart. The device ensures that clots don’t travel to the lungs. These filters are fitted in patients who can’t use blood thinners for medical reasons. If you also develop clots or bleed when taking blood thinners, a vena cava filter is ideal. 
• Pulmonary embolectomy: This is usually the last option if blood thinners don’t work. It’s also recommended if you are not responding to other treatments. Pulmonary embolectomy is surgery performed to remove a blood clot. 
• Percutaneous thrombectomy: This involves using a long and hollow tube that is inserted through a blood vessel. The tube is thin and is guided to the embolism site. When in place, the clot is broken down, dissolved, or pulled out. It is a less invasive procedure and one that is very effective. 

How to Live With and Manage Pulmonary Embolism

Pulmonary embolism is preventable and the only way to do that is to make sure that clots don’t form in your legs. Prevention may involve; 

• Taking blood thinners. Patients on blood thinners need to have regular checkups. These ensure that the medication is working and not causing any bleeding.
• Lifestyle changes like quitting smoking, exercising, eating healthy can ensure that PE doesn’t recur.
• Use of compression stockings to prevent DVT. 
• If you are sitting for long periods, try and move your legs a little to prevent blood clots.
• After surgery, try and move around since blood clots are possible after surgery and when on bed rest.
• Take plenty of fluids to prevent dehydration which can lead to blood clots.

FAQ

1. What are the common risk factors for pulmonary embolism? You are at risk of developing a pulmonary embolism if you have heart disease or had surgery recently. You may also develop PE if you have pancreatic, lung, or ovarian cancer. PE also develops if you are being treated with chemotherapy or have a family history of PE. Other risk factors include sitting for long in one position, smoking, pregnancy, and obesity.
2. Is pulmonary embolism treatable?  30% of people with untreated pulmonary embolism die within a month. However, if you seek treatment early, it is treatable. Blood thinners prevent future blood clots while thrombolytic therapy helps dissolve blood clots. 
3. How long do I have to be on blood thinners? This will depend on your risk of blood clots in the future and what caused the clot. For clots caused by surgery or trauma, blood thinners only need to be taken for a year or less. If the embolism is not caused by a temporary condition, you may have to be on blood thinners all your life. 

Healthier Me Today is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice in seeking treatment, always consult with your healthcare professional. Stay healthy!