Thrombosis Pulmonary Embolism

A comprehensive overview of pulmonary embolism covering subjects as: treatment, symptoms, diagnostics, research, causes, pictures and images
Thrombosis Pulmonary Embolism

Thrombosis pulmonary embolism

     The thrombi (clots) that cause thrombosis pulmonary embolism may dissolve on their own. However, after an episode of thrombosis pulmonary embolism increases the risk of relapse if the treatment is not prescribed and taken. If the diagnosis of thrombosis pulmonary embolism is as soon as the first symptoms appear, treatment with anticoagulants (usually with warfarin and heparin) can prevent new thrombus.

     The risk of developing a new episode of thrombosis pulmonary embolism (recidivism) is different at the other thrombogenic substances. Substances that are reabsorbed such as air, fat, amniotic fluid, do not increase the risk of thrombi relapsing but the cancer can significantly increases this risk.

     After multiple episodes of thrombosis pulmonary embolism blood flow can be significantly reduced to the lungs and heart. This phenomenon can lead to increased pulmonary pressure (increased pressure in the pulmonary artery), right heart insufficiency and, in some cases, even death.

Symptoms of thrombosis pulmonary embolism thrombosis

     Signs and symptoms vary in intensity and frequency and they are not specific to this disease, that means that they can occur in many other illnesses, which delays diagnosis and treatment more.

     If the lung area affected is very high, death occurs before the doctor has a chance to examine the patient. Signs and symptoms depend on the size and location of the thrombi, meaning the affected tissues, the existence of cardiopulmonary disease and the association of a pulmonary infarction.

     The signs and symptoms are:

  • Dyspnea (sensation of suffocation)
  • Chest pain
  • Cough with or without expectorations with blood
  • Palpitations
  • Syncope (unconsciousness)
  • Leg pain and / or swelling of her
  • Tachycardia and tachypnea (the increased amplitude and the number of breaths per minute)
  • Pallor or cyanosis
  • Fever
  • Heavy sweating
  • Anxiety and fatigue
  • Wheezing (whistling expiration)
  • Other evidence discovered by doctors during examination.

Treatment for pulmonary embolism

     There are two types of treatment: prophylactic (preventive) and curative (healing).

     Prophylaxis is the prevention of deep vein thrombi appearance and / or thrombosis pulmonary embolism. It is indicated to those who are to undergo a surgery, boarding, restrained to the bed for a long time. It consists in the administration of anticoagulants, early postoperative mobilization, massage, graded compression stockings, pneumic intermittent compression and filter for the inferior vena cava. The filter for the inferior vena cava is indicated in recurrent thrombosis pulmonary embolism, where there is an increased risk of right heart failure and even death.

     The curative treatment consists of:

     Injectable anticoagulants: unfractionated heparin fractionated Dextran, Clexane, oral anticoagulants coumarin Sibtrom, thrombi stop, Warfarin. The last one is not indicated during pregnancy, because it effects the normal development of the fetus.

     Thrombolytic therapy consists of infusing the substances that help the decomposing of the thrombus which generated thrombosis pulmonary embolism. It is applied in the first 6 to 12 hours after the onset.

     Surgical treatment: consists of surgically removing a part of the lung id the thrombus is to large.

     Paraclinical explorations have a relatively limited role in the emergency diagnosis of massive thrombosis pulmonary embolism. It is done primarily based on clinical data, their growing role in the diagnosis of atypical or recurrent forms, when applying aggressive therapy (which requires correct diagnosis).

Laboratory tests.

     There are no specific laboratory tests for the diagnosis of thrombosis pulmonary embolism, but a bunch of tests may be useful for both strengthening clinical suspicion and especially for differential diagnosis.

     The blood count may show a mild leukocytosis, 10.000/mmc around, but most patients have a number of white blood cells and normal leukocyte formula, unlike bacterial pneumopathies. There may be biological signs of inflammation (ESR, fibrinogen increased, etc.), but their presence is inconstant and without direct significance.