A pulmonary embolism is when vessels to the lungs are blocked by a blood clot, preventing the lungs from receiving an adequate supply of blood. Often, a pulmonary embolism is caused by a thrombosis. A pulmonary embolism can have life-threatening consequences and should therefore be treated and cared for medically as soon as possible.
What is pulmonary embolism?
A pulmonary embolism results from the blockage (blood clot) of a blood vessel in the lungs. Click to enlarge. Pulmonary embolism is a very serious condition that people of any age can get. There are several causes that can lead to the development of this condition. More specifically, a pulmonary embolism means that blood clots form in one or more veins, which are then transported further and reach the heart, among other places. There, they may clog some blood vessels, which can then lead to a pulmonary embolism. These blood clots can form in several parts of the body, especially in the joints of the extremities, as is very common in the legs. So, this condition can be defined as blood clots blocking the circulation of blood and thus not being able to carry the important oxygen to the lungs.
Causes
The most common cause of pulmonary embolism is sitting or lying down without being able to move, so that veins in the joints are pinched off, triggering an embolism. Most commonly, this causes a blood clot, or thrombus, to form in the veins of the legs or even the pelvis. An example is sitting for a long time in an airplane, where you do not stretch your legs and a pulmonary embolism can develop. If one or even both legs start to hurt or even thicken, you need to see a doctor at the latest. In inexperienced divers who ascend too quickly from great depths, a pulmonary embolism can also occur. This is caused by gas bubbles forming in the veins or arteries, which can then also block the blood supply to the heart and thus the lungs cannot be supplied. During a prolonged hospital stay, pulmonary embolism is prevented by injecting blood-thinning agents.
Symptoms, complaints, and signs
Before a pulmonary embolism occurs, a number of warning signs usually appear, such as coughing or whistling breathing. These symptoms gradually increase in intensity and eventually lead to pulmonary embolism. This is usually noticeable by sudden onset of shortness of breath and chest pain. The pain can radiate to the shoulder or abdominal region. Sufferers experience anxiety and nervousness, often accompanied by palpitations, coughing and hemoptysis. In severe cases, fainting or even heart failure occurs. Pulmonary embolism usually occurs in more severe episodes. At first, those affected experience only imperceptible symptoms, which increase in intensity and duration with each blood clot. Typical symptoms are palpitations and an irritating cough, but also fever, although the symptoms often disappear on their own. Eventually, a severe pulmonary embolism occurs, which can cause life-threatening complications. In addition to the typical chest pain, which occurs mainly during intense breathing movements, there may be shortness of breath and noises during breathing. In extreme cases, a pulmonary infarction occurs, which is manifested by coughing up blood, fever and shortness of breath. Right heart failure results in congested neck veins and water retention in the legs.
Course of disease
The course of the disease pulmonary embolism is painful and must be treated immediately. There are also individuals who are more prone to thrombosis than others. These affected individuals are so-called high-risk patients. Those who have had fractures of the hip or legs and even have to wear a prosthesis are just as susceptible to pulmonary embolism as patients who have had major surgery. Age also plays a role, or serious illnesses such as stroke or malignant tumors. However, the actual pulmonary embolism occurs after a blood clot detaches and makes its way through the veins and arteries toward the heart. This happens when you stand up after resting for a long time and perform strenuous movements right away.
Complications
Pulmonary embolism can cause various complications. In addition, some late effects are possible. Among the most common effects is pulmonary infarction.This is seen in around 25 percent of all pulmonary embolisms and occurs 12 to 25 hours after the embolism. Due to the lack of blood supply to the lung tissue, which is supplied by the blocked pulmonary artery, the tissue is irreparably damaged. This is often manifested by a bloody cough. Another frequent consequence of pulmonary embolism is right heart failure (weakness of the right heart). Thus, an occlusion of larger pulmonary vessels causes an increase in pulmonary circulatory resistance. The reason for this is that too many vessels are subject to blockage. As a result, the right ventricle has to work harder than usual. If this leads to its overload, there is a risk of malfunction or even total failure of the right side of the heart. Life-threatening cardiac arrhythmias are also possible as a result of the overload. It is not uncommon for a pulmonary embolism to cause pneumonia. Because the parts of the lungs with poorer blood supply also have poorer ventilation, harmful germs can spread more easily in the lung region and cause inflammation. Sometimes inflammation of the lung pleura also occurs, which physicians refer to as pleurisy. Another complication of pulmonary embolism can be pulmonary hypertension. If pulmonary embolisms occur repeatedly, this results in permanent changes in the pulmonary vessels. To counteract the higher resistance, the heart increases its pumping capacity. As a result, high blood pressure occurs in the lung region, which in turn has a detrimental effect on the heart.
When should you go to the doctor?
If symptoms such as shortness of breath or shortness of air occur, a visit to the doctor is recommended. Due to the lack of oxygen supply to the organism, serious complications can arise or a life-threatening situation can develop. If there is chest pain, a feeling of pressure in the chest, or difficulty breathing, a doctor is needed. Complaints such as shoulder pain, noises during breathing, coughing or fever should be investigated and treated. If bloody sputum or coughing up blood occurs, a doctor’s visit is advised as soon as possible. Changes in heart rhythm, increased respiratory rate, and palpitations are signs of an irregularity present. A physician should be consulted to determine the cause of the symptoms. If daily tasks can no longer be performed as usual, general performance drops or sleep disturbances set in, the affected person needs medical help. Abdominal pain or digestive disorders should be clarified by a doctor if the inconsistencies continue unabated for several days. If there are disturbances of blood circulation, discoloration of the skin or internal weakness, a doctor is needed. A visit to the doctor is also necessary if emotional discomfort sets in. If anxiety, panic, abnormalities in behavior or mood swings occur, further investigation should be initiated.
Treatment and therapy
Once pulmonary embolism has been diagnosed, treatment must begin immediately. Because this condition is always life-threatening, treatment in the hospital involves immediate oxygenation and infusion of blood-thinning agents to prevent further blood clotting. Likewise, the coagulants are used to prevent further blood clots from forming and making the disease worse. These medications must be taken for several more months, possibly in tablet form or even as injections, to prevent another pulmonary embolism. As an additional treatment measure, anti-thrombosis stockings are also suitable, which the patient should wear while still in the hospital bed. The stockings are also worn as a preventive measure in patients at risk. Equally important is the movement of the patient, that is, he should quickly get back on his feet and stabilize the blood circulation through movements.
Outlook and prognosis
A prognosis cannot be made in a blanket manner. It must take into account the patient’s health and the extent of the disease. Doctors have classified several degrees of severity of pulmonary embolism. Mild cases are rarely fatal, whereas severe cases are fatal in every other case. Generally, it can be stated that advanced age and poor physique decrease the likelihood of survival. On the other hand, immediate consultation of a physician increases the probability of recovery. The first period after the onset of symptoms poses the greatest risk.90 percent of all patients who do not survive a disease die within the first two hours. In the event of a pulmonary embolism, the patient’s life is in danger. Waiting and hoping for improvement are not options. Once the disease has been overcome, there is a risk of a new embolism. This can be countered by taking anticoagulants. Rarely, permanent high blood pressure develops in the lungs. Patients increase their chances of a symptom-free life by discontinuing unfavorable habits. For example, reducing obesity and abstaining from nicotine have been shown to help prevent recurrence of pulmonary embolism.
Prevention
Pulmonary embolism can be prevented by giving up smoking and getting plenty of physical activity or exercise. In addition, a healthy diet helps. Avoid being overweight. Drink enough fluids.
Aftercare
Pulmonary embolism is best cured with a healthy lifestyle. This means maintaining as stress-free a daily routine as possible, getting enough exercise in the fresh air, and getting enough sleep. Rest and relaxation are important to recover from the stresses and strains. In this context, uplifting conversations with loved ones from the immediate environment can help to reduce the mental strain and promote a positive attitude to life. Regular check-ups with the attending physician ensure that the recovery process is kept in view and any complications are detected in good time.
What you can do yourself
The patient should always call the emergency physician immediately in the event of a pulmonary embolism. If it is not possible for him/herself for health reasons, observers have the duty to contact an emergency physician. Furthermore, taking first aid measures is necessary until the arrival of the physician. In addition, an adequate oxygen supply is important for the patient. People who are at risk for thrombosis should take several precautions. Rigid postures or prolonged sitting as well as standing should be avoided. Likewise, positions that could pinch limbs or blood vessels should be avoided. The body needs sufficient and regular exercise to prevent blood stasis. Circulatory stimulating activities have a positive effect on the prevention of pulmonary embolism. In addition, stays in rooms with high levels of pollutants should be avoided without an appropriate mouthguard. The activity of the lungs may be affected or tissue damage may occur. In the case of aching legs that cannot be attributed to a short-term overload, the affected person should make changes. Sporting activities or wearing healthy footwear are helpful. Shoes with high heels or the wrong sizes cause cramping, which can be harmful to the circulation and blood vessels.
