Pulmonary Embolism (PE): Causes, Symptoms, Diagnosis, and Treatment

Introduction

Pulmonary embolism (PE) is a critical medical condition marked by the sudden blockage or reduced blood flow in the lungs, typically caused by a blood clot that travels from other parts of the body. It poses serious risks and requires immediate medical intervention.

Causes

• Most common cause: Blood clot (deep vein thrombosis, DVT) originating in a leg or arm vein and traveling to the lungs’ arteries.
• Rare causes: Air, fat, tumor fragments, or other tissues in the bloodstream that reach the lungs.

Risk Factors

Factors that elevate the risk of PE include:

• Traumatic injury (e.g., broken hip or leg).
• Medical conditions such as spinal cord injury, major surgeries, stroke, blood clotting disorders, chronic lung or heart disease, cancer (especially during chemotherapy), and more.
• Lifestyle factors: Pregnancy, postnatal period, age over 60, obesity, smoking, sedentary lifestyle, extended periods of sitting (e.g., long flights), and immobilization.

Signs and Symptoms

PE symptoms arise suddenly and consist of:

• Shortness of breath during rest or activity.
• Coughing, sometimes with bloody mucus.
• Chest, back, or shoulder blade pain worsened by deep breaths.
• Rapid or irregular heartbeat.
• Dizziness, fainting, anxiety.
• Pain and swelling in the leg, indicating DVT.

Diagnosis

Diagnosis involves:

• Medical history assessment.
• Physical examination.
• Diagnostic tests such as blood tests, ECG, CT pulmonary angiography, lung VQ scan, and ultrasound for DVT detection.

Treatment

• Tailored treatment based on underlying causes, bleeding risk, and medical history.
• Aim to prevent clots from forming or growing.
• Medications include blood thinners (anticoagulants) and fibrinolytics (clot-dissolving drugs).
• Procedures like embolectomy (removing blood clot through a tube) or catheter-directed thrombolysis (destroying clot with medicine).
• Surgery for clot removal (surgical embolectomy) is rare.

Home Care

• Medications: Follow healthcare provider instructions, particularly for blood thinners. Avoid aspirin and NSAIDs without consultation.
• General Instructions:
  • Stay active, avoid prolonged immobility.
  • Maintain a healthy weight.
  • Quit nicotine and tobacco products.
• Special Considerations:
  • Discuss travel plans with healthcare provider to ensure consistent treatment.
  • Keep all follow-up appointments.

When to Seek Medical Help

• Urgent attention required for:
  • New or worsening pain, swelling, warmth, or redness in limbs.
  • Breathlessness worsening during activity or rest.
  • Severe chest pain, rapid or irregular heartbeat, severe headache, vision changes, or serious falls/accidents.
• Emergency assistance needed for:
  • Blood in vomit, stool, urine.
  • Continuous lightheadedness, inability to move limbs, confusion, or memory loss.

Conclusion

Pulmonary embolism is a life-threatening condition characterized by a sudden blockage of blood flow in the lungs due to a clot or other factors. Immediate diagnosis and treatment are crucial to mitigate the risks associated with this condition. Adhering to medical instructions, maintaining a healthy lifestyle, and promptly seeking help for symptoms are key in managing and preventing further complications. Always consult your healthcare provider for personalized guidance and address any concerns.