Pulmonary Embolism

General Information

If a blood clot forms in the circulation in a vein, it may become dislodged and be carried through the blood vessels, through the heart, and into the lungs. In the lungs, it will become trapped when it plugs a blood vessel. Such a clot formed in the circulation and carried to the lung is a pulmonary embolism.

A pulmonary embolism is dangerous and can lead to death. There is effective treatment, but the problem may be difficult to recognize. No symptom is completely characteristic, but there is a collection of symptoms that, when they occur together, can suggest pulmonary embolism as a diagnosis.

Shortness of breath, a common accompaniment to pulmonary embolism, and chest pain, a particular kind of pain that occurs on taking a deep breath called pleuritis or pleuritic pain, are common with a pulmonary embolism. Coughing up blood is another signifi- cant indicator. Less specific symptoms, but also common, are fainting, anxiety, unease, and calf pain or swelling, or both.

Important Points in Treatment
The principal treatment is anticoagulation (blood thinning). Other measures include breathing oxygen to help the heart, relieving anxiety, and relieving pain or discomfort.

Anticoagulation involves some risk for bleeding. Careful monitoring is needed to ensure that the bleeding tendency is kept inside certain limits. The patient should take anticoagulant medicines regularly.

Some patients, because of other diseases or problems, are at high risk for bleeding, and other alternatives to anticoagulation may be considered. Many elderly patients fall into this group.

Patients with other diseases that may predispose them to the development of clots and an embolism may require anticoagulation even though they have not had a pulmonary embolism. This is called prophylactic anticoagulation and is done to prevent clots from forming in a patient at high risk. Patients with atrial fibrillation, venous insufficiency, or a history of thrombophlebitis in the legs are particularly at risk. Patients with a history of one pulmonary embolism are at some risk for a second.

Notify Our Office If ...

• You develop leg swelling.
• You begin to cough up blood.