Causes and risk factors:
Pulmonary embolism mostly occurs during post operative period or due to immobilization for long period. Obesity, Trauma, fracture or long automobile or plane trips, smoking, pregnancy are some of the predisposing factors. Certain diseases like congestive heart failure, cancer, kidney problems also lead to embolism in pulmonary artery. Elevated levels of clotting factors and thrombophilia (abnormality of blood coagulation which causes blood clots) can lead to pulmonary embolism.
Clinical presentations:
Shortness of breath, difficulty in breathing and cough along with chest pain are the hallmark of pulmonary embolism. The patient complaints of sever intense or sharp pain in the chest. The cough is along with expectoration which can be mixed with blood. Dizziness, excessive sweating, bluish discoloration of the skin and rapid heartbeat are the other associated symptoms seen. Sometimes patient may collapse or pass out
Diagnosis and investigations:
Symptoms narrated by the patient along with examination carried out by the doctor will help in confirming the diagnosis. Pulmonary angiogram is the diagnostic investigations recommended. Pulmonary artery or cardiac catheterization along with routine blood test, ECG and Chest X ray are advised. Various Scans of the chest like CT or MRI can be done.
Treatment:
Prompt treatment should be adopted to avoid danger to life. Pulmonary embolism is delt with medications like anticoagulant and thrombolytic agents. Tissue plasminogen activator (TPA) can also be prescribed. In severe cases surgical intervention like removal of the clot and inferior vena cave filter therapy can be done. Embolectomy although uncommon can be done. Till the diagnosis is made patient is stabilized with supportative symptomatic line of treatment in hospitals.
Recent update:
Experts from the Perelman School of Medicine at the University of Pennsylvania have revealed after their study that adding clot-busting medications known as thrombolytic to conventional approaches when treating sudden-onset pulmonary embolism patients is associated with 47 percent fewer deaths than using standard intravenous or under-the-skin anticoagulant medications alone.
