Pulmonary Embolism

Pulmonary embolism

     Pulmonary embolism is the obstruction of pulmonary arteries. Once the artery is blocked, usually by one or more emboli, blood oxygen level decreases and pulmonary pressure increases.

     Pulmonary embolism caused by large thrombi may cause sudden death, usually within 30 minutes of symptoms. The smaller thrombi can cause irreversible damage to the heart and lungs.

Prophylaxis

     Daily use of anticoagulants may be useful in preventing the recurrence of pulmonary embolism by preventing new thrombus formation, and stopping the development of the existing thrombus.

     Recent studies have shown that the risk of a new thrombus formation is bigger during the first 4-6 weeks after an initial episode of pulmonary embolism. This risk decreases over time. However the risk remains significantly large for months and even years, depending on the cause that triggered the pulmonary embolism. People with recurrent thrombus or pulmonary embolism may be forced to follow anticoagulant therapy for the rest of their life, without pauses. Anticoagulant drugs are frequently administered to persons who are to undergo surgical operations of the lower limbs, abdomen or pelvis.

     There can also be used some other preventive methods. Among these include:

• Early mobilization after surgical interventions
• The use of compression stockings (elastic) by persons presenting the risk to develop this disease may prevent venous thrombosis
• Administration of small amounts of aspirin before taking a long journey by plane or car.

     Aspirin may reduce your risk of blood clots but it is not appropriate to treat pulmonary embolism.

Important to know about pulmonary embolism

     Once the diagnosis of pulmonary embolism, the physician determines:

• If anticoagulant treatment is necessary
• The period the patient must undergo treatment with anticoagulants

     Normally, if a recent stroke, recent surgery or active internal bleeding occurred the use of thrombocytes is not recommended. A filter placed in the vena cava may help reduce the risk of developing a new episode of pulmonary embolism.

Advice for people taking thrombolytic treatment:

• Medicines to be taken at the same time each day
• Doctor should be consulted about the administration of other drugs, especially those containing aspirin
• The emergence of signs of bleeding must be taken into account and the doctor must be announced at the appearance of the following symptoms:
• Blood in the urine, persistent red or black stool
• Nose bleeds that are hard to stop
• Vaginal bleeding new, abundant and for a long time
• Frequent and severe bruising or red or blue spots on the skin
• Depending on the medicine, patients will do take blood tests from time to time.

Tips for persons who are treated with warfarin:

• Regular blood tests to check if the product is at the optimal dose
• Food should be balanced: the patient should not suddenly reduce the intake of products that consist high reserves of Vitamin K: broccoli, Brussels sprouts, cabbage, asparagus, lettuce, spinach and some fruit juices, is very important to eat regular diets high in vitamin K
• Avoiding alcohol abuse: chronic use (long) can damage the liver and thus enhances the effects of warfarin
• Smoking is forbidden
• Avoid high risk activities such as skiing accidents, football or other sports that require physical contact (in those treated with warfarin, a hard enough contact can lead to excessive bleeding)
• Wearing seat belt.

     Preventing minor bleeding during anticoagulant treatment is important.

     These items may be necessary to reduce the risk of bleeding:

• Electric Shavers
• Soft bristled toothbrush
• Protective clothing: gloves and shoes
• Anti slipping mat for the shower or tub.

Treatment

     Treatment of pulmonary embolism requires immediate hospitalization; it consists in treating both the symptoms and consequences especially embolism by administering oxygen and preventing the extension of existing clots and the formation of new clots with an anticoagulant, heparin, administered by vein and then replaced by taking of the K anti vitamin orally for 3 to 6 months. In the worst forms, thrombocytes such as streptokinase or urokinasis allow dissolution of existing clots.

     Preventive treatment of a pulmonary embolism that follows a leg thrombosis or the abdominal region consists of early mobilization after birth or after surgery or the content of the member in case of orthopedic surgery on one leg, with the prescription of subcutaneously heparin.

     The pulmonary embolism term refers to the pathological condition which results from the embolization of the pulmonary arteries and the consecutive obstruction of the thrombi formed in the venous system or / and right part of the heart. The pulmonary thrombosis term pulmonary thrombus embolism, venous thrombi have the same meaning as the term of embolism or pulmonary embolism (PE).

     According to many statistics, pulmonary embolism would be the most common lethal pulmonary disease, with even more deceases that pneumonia and bronchial cancer.

     The main risk factors for pulmonary embolism are: age over 60 years, immobilization in bed, over 3-5 days, congestive heart failure, acute heart stroke, untreated with anticoagulants, malignancies (ex lung location, digestive), large surgery in the abdomen, small pelvis, femur and hip orthopedic surgery, pregnancy and the postpartum period, oral contraceptives containing estrogen, obesity, history of TV or pulmonary embolism, clotting, venous catheters, prolonged maintained.

Laboratory Tests

     Study of coagulation and fibrinolysis is performed mostly in special scientific research - in hopes of finding specific and sensitive biological changes for the pulmonary embolism. Degradation of fibrinogen / fibrin is raised in pulmonary embolism.

     PaO2 and PaCO2 determination is useful, in part for the pulmonary embolism diagnosis, but especially for its treatment. Virtually all patients with significant pulmonary embolism have hypoxemia. This is why normal PaO2 values tend to exclude massive pulmonary embolism.