Doctor's Notes on Pulmonary Embolism
A pulmonary embolism (PE) is a blood clot in the lung. The signs and symptoms of a PE are as follows: sharp and stabbing chest pain that increases with a deep breath, short of breath (especially with exertion), anxiety, cough (may produce some blood), sweating, and passing out. In addition, the patient may have other signs that relate to a PE such as having a DVT (deep vein thrombosis), a swelling, pain, warmth, and redness of an arm or leg.
The immediate cause of a PE is a clot blocking blood flow in the lung. Risk factors for PE development include immobilization (for example, people with a stroke, bone fracture, or spinal cord injury), travel with prolonged sitting, recent surgery, trauma (especially to the legs), obesity, burns, and a previous DVT. Any condition or disease that increases blood clotting (cancer, pregnancy, medicine, or treatments like oral contraceptives) can be a risk factor for a PE. A PE can be fatal. If you suspect you have one, go to an emergency department or call 911.
What Are Treatments for a Pulmonary Embolism?
The most common treatment for a PE is blood thinners (anticoagulants). They can be given orally, and some can be administered by IV:
- Warfarin (Jantoven, Coumadin)
- Dalteparin (Fragmin)
- Enoxaparin (Lovenox)
- Tinzaparin (Innohep)
For life-threatening pulmonary embolisms, thrombolytic drugs are administered by trained hospital caregivers to break up clots. Another method that is occasionally used is embolectomy, a surgical technique that inserts a thin tube through a vein that eventually reaches the PE in the lung. Then the PE is removed or dissolved with a thrombolytic.
DVT (Deep Vein Thrombosis) and Pulmonary Embolism (PE) QuizQuestion
Deep vein thrombosis (DVT) occurs in the _______________.See Answer
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DVT (Deep Vein Thrombosis Blood Clot in the Leg)Deep vein thrombosis (blood clot in the leg, DVT) is a blood clot imbedded in one of the major veins of the lower body, including the legs, thighs, or pelvis. Disease and conditions that put you at risk of DVT are many, and include heart disease, heart attack, heart failure, pregnancy, estrogen therapy, prolonged periods of immobility, for example, sitting while traveling or confined to bed, trauma, being overweight, cancer, respiratory conditions, and advanced age. Symptoms of DVT include redness and warmth to the touch, leg swelling, pain or tenderness in the leg, redness or discoloration of the skin on the leg, leg cramps, edema, and pain. Treatment for a blood clot in the leg include medications, a vena cava filter, and graduated compression stockings. . You can prevent blood clots in the leg by moving around during prolonged periods of immobility, taking your medicine as your doctor has prescribed, getting up and moving as soon as possible after surgery or an illness (this lowers your chances of getting DVT), and exercising your leg muscles during long trips (particularly the lower leg muscles).
PhlebitisPhlebitis is the inflammation of a vein. Superficial phlebitis affects the veins on the surface of the skin. Deep vein thrombophlebitis affects the larger veins deep in the veins. Blood clots in the legs can form from deep vein thrombophlebitis and potentially lead to pulmonary embolism.Causes of phlebitis include sedentary lifestyle, smoking, varicose veins, cancer, hormone therapy, birth control pills, obesity, or injury to the legs or arms. Symptoms and signs of phlebitis include red, tender, warm, hard, throbbing, or burning feeling along the skin. Fever, may sometimes be present. Treatment depends on the location and severity of the condition.
Varicose VeinsVaricose veins are thought to be inherited in some people. Other caues of varicose veins include pregnancy, prolonged standing, obesity, straining (constipation, chronic choughing, enlarged prostate, etc.), prior surgery to the leg, and age. Treatments for varicose veins include several modalities and surgery.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.