The All-In-One Guide to Pulmonary Embolism

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A report by the National Heart, Lung and blood institute suggests that approximately half of the people suffering from pulmonary embolism do not display any symptoms at all. As a matter of fact, most of them are not even aware that they have the condition. About 300,000 to 600,000 people are affected by pulmonary embolism on an annual basis in the United States alone. The same number is also affected by deep vein thrombosis.

Regardless of the symptoms that are present, pulmonary embolism is a very serious and dangerous condition. It could at times be life-threatening. Its unpredictability has become one of the scariest things about the condition. It can cause drastic reactions without any prior warnings. Some of the symptoms include chest pains, change in breathing pattern, increase in heartbeat, among others. Someone who’s going through these symptoms may assume them to be another illness such as acid reflux, respiratory infection or any other passing infection.

There are some preventions and treatments that will help you to lower your risk of contracting this condition. They include: remaining active, maintaining a healthy weight, exercising and improving your diet. If your veins are injured, take special precautions. Visit a hospital, the trauma wing or post-surgery.

What is Pulmonary Embolism?

Pulmonary embolism (also referred to as PE) is a very serious condition. Its major symptom and also its identifying factor is a blood clot that manifests in a lung artery. The major cause of this condition is a clot that has traveled from the leg to the lung of the patient.

Deep vein thrombosis (or DVT) is the blood clot that occurs in the leg. When one has DVT, the clot may break away from the original location. It then makes its way through the body, via the bloodstream and settles somewhere else; this may be the brain or the lungs. Permanent damage may occur if the clot blocks normal circulation from taking place in the lungs. This is due to the reduced amount of oxygen. Death may even occur. Due to complications arising from this situation, three out of ten of all patients suffering from pulmonary embolism will die. Some may also die from the death of the healthy cells as well as tissue damage.

What is Deep Vein Thrombosis?

When a clot develops in a vein that is located in some deep part of your body, DVT occurs. It is a very deadly condition. A blood clot is a gelatinous and solid state clump of blood. Clots in the deeper veins usually occur in the thighs or lower legs, though they also occur in some other parts of the body. Thromboembolism, postphlebitic syndrome, and post-thrombotic syndrome are just some of the names that are associated with this deadly condition.

Who’s at Risk of Developing Deep Vein Thrombosis?

DVT has a higher probability of occurring in people aged 50 and above. There are some specific conditions that affect the movement of blood in your veins, which can consequently lead to the development of clots.

These include:

  • Having a bone fracture or other injuries that damage your veins.
  • Being overweight. This increases the pressure on the veins in the pelvis and the legs as well
  • Having a history of DVT in the family
  • Having a catheter placed in one of your veins
  • Undergoing hormone therapy or taking birth control pills
  • Smoking (heavy smoking, especially)
  • Staying seated for long periods of time. It may be in a car or a plane. Chances increase if you already have other risk factors.

The risk of having blood clots in your veins is increased by specific diseases and disorders. These diseases work together with other risk factors, in many cases just one, in order to create a clot. A major condition is hereditary blood clotting disorders. Other conditions that increase the risk of having blood clots include inflammatory bowel disease and cancer. Heart failure, which makes it increasingly difficult for the heart to pump blood, also increases the risk of contracting clots.

Pregnancy

Pregnancy increases your risk of developing deep vein thrombosis. Increased hormone levels as well as restriction of normal blood flow due to the expansion of the uterus increases this risk. It is not until after six weeks of giving birth that this risk subsides. Bed rest for long periods of time and cesarean delivery also increase the chances of you developing DVT.

When to See a Doctor?

You should be concerned about DVT, but when exactly do you need to see a doctor about it?

Given the seriousness of this condition, you should go to the nearest emergency room or contact your doctor immediately if you suspect that you are suffering from deep vein thrombosis. Your healthcare provider will advise you on the best route to take after examining all your symptoms and going through your medical history.

You can also schedule an appointment with your doctor if you have any concerns at all that you may be at risk of developing this condition. You need not have the condition to express these concerns. Preventive treatment may be an option for you. Your doctor will advise you best on this.

What Are the Causes of Pulmonary Embolism?

Blood clots normally form due to various reasons. Pulmonary embolisms are primarily caused by DVT, also a serious condition in which blood clots form in the veins. The blood clots which advance and later lead to pulmonary embolism are usually formed in the pelvis and legs.

Formation of blood clots in the veins is usually caused by various factors.

They include:

Injury or Damage. Muscle tears, bone fractures, and other injuries may lead to damage of blood vessels which consequently leads to clots.

Inactivity. Gravity causes the blood to remain in the lowest parts of the body when one remains inactive for long periods of time. This eventually leads to blood clots. This could happen if you’re on bed rest due to a certain illness or maybe you are sitting during a long trip.

Medical Conditions. Some health conditions as well as diseases cause the blood to clot easily, which may, in turn, lead to pulmonary embolism. Chemotherapy for cancer, surgery, and treatments for other health conditions also lead to blood clots.

Other than those stated above, there are more factors that may increase your chances of developing the specific type of blood clot that causes pulmonary embolism.

Risk Factors

The risk factors that may lead to pulmonary embolism are the same as those that lead to deep vein thrombosis.

They include the following:

Old Age. The risk of developing blood clots increases with increase in age. Arterial damage and other risk factors for pulmonary embolism are more likely to happen in older adults than in young adults. If they are suffering from another illness, are overweight or obese, the risk is much higher. The risk of PE occurring in children is said to be very low at one in one million. However, after 40 years of age, the risk continuously doubles with each decade.

Being Overweight. The risk of developing blood clots, in overweight or obese people is higher due to constant and unpredictable changes in blood pressure, inflammation and also due to the increase in estrogen levels due to excess fats.

Too Little Exercise. Poor blood flow and clot development have a higher chance of occurring if one leads an inactive lifestyle. Surgery, bed rest, pregnancy and obesity are some of the most common causes of inactivity. The chances of clots occurring in these people are higher than in those who lead a more active lifestyle. Other circumstances that may lead to the occurrence of clots include watching TV for extended periods of time, sitting at your desk all day long, taking long car rides and flights and also immobilization after surgery. These factors, however, have a less chance of causing blood clots. They begin the process of developing DVT.

History of Blood Clots and Stroke. People with a history of cardiovascular problems are more likely to develop this illness than people who have no history of heart attacks, heart diseases, strokes, unhealthy blood pressure or arterial damage. People who have had their veins injured from traumatic impacts or due to surgical procedures are also at a higher risk of developing DVT or pulmonary embolism more easily.

Hospitalization. About 20 percent of all reported cases of pulmonary embolism occur in the hospital. This is mainly due to triggers like healing from surgery, immobilization, dealing with stress and trauma, treatment with intravenous catheters (which lead to increased risk of clotting), blood pressure changes, recovering from another illness or infections.

High Levels of Stress and Trauma. Going through a traumatic event (it could be physical or mental) could increase the risk of PE or DVT tenfold! The levels of clotting factors are increased by stress and trauma. Stress and trauma also contribute to increased inflammation, alteration of blood pressure levels, and change in hormones.

Recent Infections. Due to effects on clotting, blood pressure and inflammatory processes, recent infections lead to an increased risk of pulmonary embolisms and DVT.

Chronic Diseases. Research has proven that a history of specific types of conditions including diabetes, kidney disease, arthritis, lupus, cancer and inflammatory bowel disease all lead to the development of clots. All conditions that lead to damage of the veins also contribute to the development of clots.

Smoking and Drug Abuse. Smoking worsens the risks that have been stated above. Tobacco, cigarettes, and drinking too much alcohol or use of recreational drugs leads to increased risk of developing clots.

Menopause and Hormonal Changes. According to research some activities can lead to increased risk of developing clots. These include changes in estrogen, especially increased levels due to taking birth control pills or taking hormone replacement drugs. These activities may also lead to serious heart complications. If you are already at menopause and you take drugs that replace estrogen, you are at a higher risk of developing clots if you smoke, don’t exercise or are also overweight.

Pregnancy. Most women who develop clots are usually pregnant or have just given birth. Reasons for this phenomenon include the increased pressure on the veins, more production of blood for supporting the fetus, weight gain/obesity and changes in the blood pressure. A surprising discovery is that a good number of maternal deaths that happen during birth are due to pulmonary embolism.

Genetic Factors. There are some inherited genetic traits which may lead to blood disorders. They may also cause the production of too many platelets. Other factors have to, however, involved for a clot to be formed.

Complications

This condition can be life-threatening if not attended to. About one out of three diagnosed people die from this condition. The number, however, drops drastically if the condition is diagnosed at an early stage and prompt treatment measures are taken.

Pulmonary hypertension may also arise from a pulmonary embolism. This is a condition that causes increased blood pressure in the right side of your heart and in your lungs. Your heart must work a little harder in order to push blood through the clots in your veins, hence the increased pressure. Pulmonary hypertension may lead to the weakening of your heart.

Small emboli can also occur, though this rarely happens. They develop over time and they can lead to chronic pulmonary hypertension. This condition is also referred to as chronic thromboembolic pulmonary hypertension.

Pulmonary Embolism Symptoms

These symptoms usually depend on the location of the clot in your lungs. They are also highly dependent on the size of the clot.

Shortness of breath is the most common symptom of pulmonary embolism. It may occur suddenly or gradually.

Other common symptoms of this chronic condition include:

  • Anxiety
  • Bluish or clammy skin
  • Chest pains that usually extend into the jaw, neck, arm, and shoulder
  • Fainting
  • Irregular heartbeat
  • Rapid breathing
  • Lightheadedness
  • Spitting up blood
  • Weak pulse
  • Rapid heartbeat
  • Restlessness

Should any of the above symptom arise, especially shortness of breath, seek medical attention as fast as possible.

How is Pulmonary Embolism Diagnosed?

Some conditions such as high blood pressure and emphysema may lead to difficulties in the diagnosis of pulmonary embolism in some cases.

When you visit the doctor due to symptoms, they will inquire about your general health as well as any underlying medical conditions that you may have.

The following tests will be carried out. Your doctor may choose to perform just one or several depending on your symptoms:

Chest X-Ray. The test is standard and noninvasive. It allows the doctor to have a good look at your lungs and heart in detail. Problems with the bones that surround your lungs are also visible.

Electrocardiography (ECG). This test is used to measure the electrical activity of your heart.

MRI. The test produces detailed images by use of a magnetic field and radio waves.

CT Scan. This scan produces cross-sectional images of the lungs, allowing your doctor to make a more accurate diagnosis. A V/Q scan may also be ordered for more accurate diagnosis.

Pulmonary Angiography. A small incision is made through which your doctor guides specialized tools through the veins. A special dye is also injected so that the blood vessels of the lungs can be visible.

Duplex Venous Ultrasound. Radio waves are used to visualize blood flow. Blood clots in your legs can also be seen when the test is carried out.

Venography. The veins of the legs are taken through a specialized x-ray.

D-Dimer Test. A special type of blood test.

Pulmonary Embolism Treatment

Pulmonary embolism is treated based on the location and size of the blood clot. If the condition is detected at an early stage and is also minor, it may be treated with medications. There are certain, medicines that have the ability to disintegrate small clots.

Drugs that your doctor might describe include the following:

Anticoagulants. They are also referred to as blood thinners. Heparin and warfarin are drugs that prevent the formation of new clots in your blood. They are effective in emergency situations and they can even save your life in such conditions.

Clot Dissolvers. They are used to increase the speed with which a clot breaks down. Due to side effects such as dangerous bleeding problems, they are normally reserved for emergency situations.

More severe clots such as the ones that inhibit the flow of blood to the heart and lungs may be removed through surgery.

There are some specific procedures that your doctor may employ, according to the Mayo Clinic, that includes the following:

Vein Filter. Your doctor makes a small incision, after which he installs a tiny filter in the inferior vena cava using a thin wire. The vena cava is usually the ink between the right side of your heart and your legs. The filter ensures that the clots cannot get to your lungs from your legs.

Clot Removal. A catheter (which is a small tube) is used to suck large clots from your arteries. Due to the difficulty involved in this method, it not an entirely effective method. It is, therefore, not always preferred to treat pulmonary embolism.

Open Surgery. This method is only used in emergency situations, such as when a person goes into shock or medications that are meant to break up the clot are not working.

Follow-Up Care

Once you have received the proper treatment for pulmonary embolism at the medical center, you will be advised to seek treatment for the underlying cause as well. This is, as earlier mentioned, deep vein thrombosis.

The most basic medications will be anticoagulants such as warfarin and heparin. These will prevent the return of blood clots. To prevent the formation of clots in your legs, you may need to wear compression stockings. They are similar to very tight socks.

As part of your therapy after pulmonary embolism treatment, you will need to exercise your legs regularly. It is a key component of your recovery process. Complete instructions will be provided by your doctor on how to prevent blood clots from occurring in the future by caring for yourself.

Pulmonary Embolism and Surgery

Though PE has lots of possible causes, the most common one is long periods of bed rest. When you don’t move around for extended periods, circulation of blood doesn’t happen as well as it should. Blood clots can form because blood usually collects or pools or collects at certain locations. Other common, but less likely causes, include tissue from a tumor, air bubbles and bone marrow obtained from a log and broken bone.

Blood is returned to the heart by the veins. if a blood clot makes its way to the heart through these blood vessels, it will then move to the lungs where carbon dioxide is disposed of and blood receives oxygen. The blood vessels reduce in size considerably. The clot can, therefore, set up shop at the vessels, causing a hindrance to blood flowing in the lungs. Under normal circumstances, oxygen-rich blood returns to the heart from where it is pumped to the rest of the body. The clot, however, blocks part of that return.

How to Prevent Pulmonary Embolism

If surgery is the chosen mode of treatment, consult with your doctor about your PE risk and what can be done to avoid it. You may be given anticoagulant medication such as warfarin and heparin (Coumadin, Jantoven) or blood thinning medication. Before and after surgery, you may be given a warfarin alternative. Though these drugs can lead to bleeding complications, they help by preventing the formation of blood clots in the body.

If a blood thinner is your doctor’s prescription, chances are high that you will continue using it at home. Make sure to fill your prescribed thinners appropriately after being discharged from the hospital. If no prescription for anticoagulants is given, make sure to ask about it. In the days and also weeks after your surgery, the risk of reemergence of clots remains high. You should, therefore, have daily doses of thinners.

You may also avoid pulmonary embolism through the following ways:

  • Quit smoking if you do, since smoking leads to damage of the blood vessels. It also raises the risk of blood clot formation and high blood pressure among other problems.
  • If you are obese or overweight, consult your doctor on how you can lose the extra weight and also keep it off.

Exercising should be made part of your life, you should do it every day. And no, I’m not talking about a 30-minute workout. The more time you spend on your legs walking, running, dancing, or any other kind of movement, the less the chances of developing pools and clots in your legs, which may later lead to pulmonary embolism.

Types of Pulmonary Embolism Blood Tests

D-Dimer

The D-dimer test will be ordered and used by your doctor to either rule out or diagnose pulmonary embolism. When a blood clot breaks down, it releases a substance. The D-dimer test is used to measure the levels of this substance in the bloodstream.

A D-dimer test need not be performed if the doctor thinks that the probability of pulmonary embolism presence is high when he carries out clinical assessments.

If the D-dimer blood test results fall either in the negative or normal range, and you also don’t have a lot of risk factors, then you most probably don’t have pulmonary embolism. If the results come back as high or positive, however, it is an indication of significant degradation in your body as well as clot formation.

A positive D-dimer result doesn’t pinpoint the exact location of the clot. As such, further tests will be required for that information to be obtained.

There are also some additional factors that may lead to a high D-dimer result. They include the following:

  • Heart attack
  • Liver disease
  • Recent surgery or trauma
  • A recent or current infection
  • Pregnancy

Troponin

This test is carried out after diagnosis of pulmonary embolism. It is used to determine whether your heart has been subjected to any damage by the PE. When damage occurs to the heart, a protein known as troponin is released into the blood; hence the name troponin test.

After a series of troponin tests have been carried out, with the results saying that there are high levels of troponin in your blood, it is an indication that your body has taken some damage.

Since troponin is released only when the heart has been damaged, the troponin test cannot be used to check for injuries to other muscles in the body, for instance, skeletal muscles.

There are other conditions which may lead to high levels of troponin. They include:

  • Kidney disease
  • Heart attack
  • Heart inflammation
  • Stable or unstable angina
  • Congestive heart failure
  • Tachycardia and tachyarrhythmia
  • A recent or current infection

BNP

Just like the troponin test, the BNP test may be ordered by your doctor after pulmonary embolism has already been confirmed to be present. Determining the level of heart failure is the main purpose of this test. If the heart is working harder than it should be to pump blood, BNP is released into the bloodstream, together with some other related compounds. Due to the blockage of important blood vessels, this can happen if one has pulmonary embolism.

The levels of BNP in youth bloodstream are directly proportional to the seriousness of the heart failure. High levels indicate a bad situation.

The following factors can also lead to high levels of BNP in the bloodstream:

  • A dysfunction of the right or left ventricle of the heart
  • Kidney disease
  • Old age

5 Natural Pulmonary Embolism Remedies

Improve Your Diet

Some people continue to wonder if eating foods rich in vitamin K increases the risk of developing PE. This is because vitamin K helps with blood clotting. This is most certainly not the case. As a matter of fact, natural sources of vitamin K are healthy options. They contain several anti-inflammatory properties. Leafy vegetables, avocados, olive oil, bananas, berries, sweet potatoes and other non-starchy vegetables, as well as unprocessed and nutrient-dense foods, should be at the top of your list of foods. These foods contain lots of antioxidants, electrolytes, and other nutrients. However, remember that vitamin K interacts with blood-thinning drugs. As such, you should be monitored if these drugs are part of your prescriptions.

Some other foods that have natural anti-inflammatory and anti-coagulant effects which reduce PE risk include:

  • Foods with vitamin D and vitamin E: available in veggies, fruits, specific types of mushrooms and cage-free eggs.
  • Spices and herbs. They include turmeric, cayenne, garlic, and ginger.
  • Real dark chocolate/cocoa
  • Raw honey
  • Fruits such as berries, papaya, and pineapple
  • Green tea
  • Apple cider vinegar
  • Evening primrose oil
  • Fish oil, omega-3 fatty acids obtained from wild fish
  • Lean and healthy protein sources including legumes, nuts, beans, fish, seeds and moderately pasteurized meat
  • Make sure to take in lots of plain water and other liquids that will keep you hydrated such as herbal tea. Alcohol, caffeine and too much alcohol will not do you any good.

Stay Active

Make sure to exercise regularly and avoid long periods of inactivity, immobilization and bed rest. This will lower the risk of developing clots. Aerobic exercises are the best for keeping your weight and blood pressure at healthy levels. It is vital to keep an exercise schedule even in old age. Keep taking regular breaks from sitting and make sure to stretch.

Maintain a Healthy Weight

The estrogen that is stored in fatty tissue often contributes to clot formation. Maintain a healthy weight even as you age to avoid the formation of clots in your blood vessels. Make sure to get enough sleep, stay active and watch your alcohol intake.

Check Your Medications

These include hormone replacement drugs and birth control pills as well as blood pressure control medications. Cancer treatment drugs also play a role in blood clotting.

Consult your doctor on matters regarding medication if you have any other PE risk factors. You should lower them if they may lead to any problems. Blood-thinning drugs should be taken under the supervision of your doctor. They include Jantoven and Coumadin.

Take Precaution After Injury, Trauma, When Travelling or When Hospitalized

According to a review in the Annals of Surgery, between 7%-57% of people who have gone through a traumatic injury develop DVT or PE. These conditions are, however, preventable. There are 6 factors that are used to predict a major problem; being aged 40 and above, suffering from head injuries, undergoing a major operation, recovery from a venous injury, injury on the lower extremity and spending 3 days in a ventilator. Research suggests that specific medications should only be used on patients who cannot undergo any other form of treatment.

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