Pulmonary embolism
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A pulmonary embolism occurs in your lungs when an artery is blocked. Most of the time this blockage is from blood clots that start out somewhere else in your body. The most common place for clots to form is your legs, but it is also possible for them to form in the veins of your arm, inside your heart, or even at the place where a needle or tube has pierced your vein. Pulmonary embolism can be very serious, but usually isn’t fatal. This is true despite the fact that it is the third-leading cause of deaths that take place in hospitals, and is a significant danger for people who take long airplane trips.


Pulmonary embolism can have a variety of symptoms, which appear in varying degrees of intensity. Some of the most common symptoms of pulmonary embolism include sudden shortness of breath; this can happen whether you are moving around or just sitting still. You may also experience chest pain that can feel like a heart attack. The pain can be anywhere in your chest and spread to your shoulder, arm, neck, or jaw. If you have an embolism, you might also have a cough that brings up bloody phlegm.


The above are the most common signs of a pulmonary embolism, but they aren’t the only ones. Some people may find themselves wheezing, or with their legs swelling up. Their skin might turn blue or become clammy and sweaty, and they may feel dizzy or even faint. They may feel a sudden onset of anxiety, and their pulse may become weak. Sometimes they will run a fever.

Embolisms occur when clots that form naturally in the blood vessels become detached and begin to circulate along with the rest of the blood through every part of the body. Sometimes these clots get stuck again, and the blood vessel gets blocked. This is a particular problem for the lung, since all blood eventually has to go through the lungs to be replenished with oxygen, and because there are so many small blood vessels in the lungs, making it easier for a blockage to occur.


Anyone can have an embolism, but there are some factors that make a person more susceptible to clots, and therefore to embolisms. One of these is prolonged inactivity. Long plane flights are one example, as are long car trips, of times when you may spend hours on end almost completely immobile. Similarly, if you are confined to your bed for long periods of time, such as happens after a surgery or serious injury or during a high-risk pregnancy, your blood flows more slowly and has more opportunities to create clots. This is why nursing home residents are at particular risk for pulmonary embolisms. Besides the bed rest required by recovery, sometimes a surgery itself can cause blood clots to form. Some of these are hip, pelvis and knee surgeries.
pulmonary embolism
Image: Pulmonary Embolism

There are also some medical conditions that you might have that can put you at higher risk for clots, and therefore for embolisms. A propensity for clots is sometimes inherited, so if a family member had a stroke, embolism, or suffered from deep vein thrombosis, you might be at increased risk. Some cancers also put you at higher risk for clots; ovarian, lung, and pancreatic cancers are especially serious because they can increase the levels of substances that assist in clotting.

Chemotherapy increases the risk of clotting, as do preventative treatments such as tamoxifen and raloxifene. Because clots can also form in the heart, heart problems such as high blood pressure and heart disease put you at higher risk for a clot in your lungs. Problems with your bowels, such as Crohn’s disease, ulcerative colitis, or other inflammatory bowel diseases can cause problematic clotting, as can being overweight.

In addition to the above risk factors for embolisms, being pregnant can also put you at risk. In fact, pulmonary embolism is the primary cause of death in pregnancy. Some women develop a disorder called venous thromboembolism, which means they are prone to clots in both arteries and veins. Another risk factor for women is taking estrogen supplements, since estrogen is thought to increase clotting. Smoking, too, predisposes people to blood clots.


About ten percent of people with pulmonary embolism die within the first hour. This is why seeking immediate treatment is absolutely crucial; in most cases, pulmonary embolism is not fatal when diagnosed and treated quickly. It can be hard to tell whether you’re experiencing an ambolism, but if you have signs that include chest pain, coughing up blood, and shortness of breath, you can be fairly confident that something serious is wrong, and you should seek help immediately.


A doctor can determine if your condition is indeed a pulmonary embolism through various tests. One of these is a chest x-ray. A chest x-ray cannot actually detect an embolism, but it can tell you that your illness is not something else that would appear. Another test is called a lung scan, which uses small amounts of radiation to determine whether the air flow and blood flow to your lungs is normal or in crisis. You might be given a CT scan, which is a very effective means of determining an embolism, but includes administering a dye so that it can be read more easily, and this dye sometimes causes allergic reactions. A more accurate, but also more risky test is the pulmonary angiogram which threads a catheter through your veins and into your lungs, but this is a difficult procedure and is only done when no other test can tell definitively if an embolism is present.


Pulmonary embolisms can be life threatening and can lead to serious complications. Some of these include pulmonary hypertension, or high blood pressure in your lungs, and heart damage. Pulomary embolisms are treated primarily with blood thinners such as heparin or warfarin, but can also be treated by implanting a vein filter so that clots are strained out before they reach the lungs.
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