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Pulmonary embolism: Some knowledge to help you breathe easier
Omar P. Haqqani, MD
Midland Daily News
December 11, 2016
As many as 900,000 people each year are afflicted with a deep vein thrombosis, and suffer from consequential blood clotting in a deep vein system as a result. In certain instances, a pulmonary embolism, or the dislodging of the blood clot from the legs or pelvis, can travel to the heart and lungs, which can be life-threatening.
A DVT is developed through a number of contributing factors, including trauma, bone fracture, cancer, varicose veins, pregnancy, birth control pills or hormones taken for menopause symptoms. Additionally, the risk of causing a DVT increases by being 60 years or older, having type A blood or an inherited tendency that increases risk for blood clots.
The effects of DVT, specifically blood clotting that occurs in the deep vein system, have the ability to dislodge clots from the vein and travel to other parts of the body. In this case, a clot can move to the lung, blocking the blood supply, and limiting or stopping blood flow to the organ.
This blockage can cause great harm to the body, as this impasse increases blood pressure in the lungs, making the heart work harder to get blood all over the body. In some cases, blood vessel blockages can be caused by substances other than blood clots, such as collagen, air bubbles or part of a tumor.
If gone uncorrected and the heart continues to overwork, the organ could enlarge to the point where it is not able to perform.
A pulmonary embolism can be difficult to diagnose because its symptoms mimic many other diseases or conditions. However, key symptoms, such as shortness of breath, chest pain and bloody cough, are telling signs of a pressing health risk that should be immediately addressed by a medical professional.
A diagnosis may be made through a combination of reported symptoms, physical examination and results of diagnostic testing. These can include chest x-ray, electrocardiography, computed tomography scan, duplex ultrasound or pulmonary angiogram.
Treatment options vary, depending on the extent of the disease, signs and symptoms, tolerance to certain medications or therapies, and one’s age and current health. The immediate goal of treatment is to prevent the clot from getting any larger and to prevent additional clots from forming.
Compression stockings and anticoagulants may be introduced initially to see if the embolism can be addressed without surgical intervention. They are worn daily and serve to reduce swelling and prevent blood from pooling in the veins, stopping the formation of additional clots.
Anticoagulants, such as Heparin or Coumadin, thin the blood and prevent the current clot from increasing in size.
If surgical intervention is required, a filter may be inserted in the inferior vena cava (IVC) by a vascular specialist. This involves the insertion of a thin, flexible tube called a catheter into a vein in the leg, arm or neck. The filter is passed through the catheter and placed in the inferior vena cava to prevent further clots from traveling to the lungs.
IVC filters have garnered a tremendous amount of media attention over the years, but have proven to be lifesaving for many patients. Generally, IVC filters should be removed within a defined period of time if anticoagulation treatment can be maintained.
Additional therapies, such as thrombolytics or suction thrombectomy, may be utilized. Thrombolytics uses a catheter that is guided to the blocked blood vessel to inject a thrombolytic drug into the area of the clot, dissolving it over a period of time.
During suction thrombectomy, a catheter is guided to the area of the pulmonary blood clot. A salt water solution is then shot into the blocked blood vessel, which can break up the clot. A rotating mechanical device attached to the end of the catheter may also be used to break up the clot for removal.
In severe cases, when clots are unresponsive to other therapies, an open surgery, known as pulmonary embolectomy, may be required. Recovery time for surgeries vary depending on the procedure, type of anesthesia and a person’s general health or age.
Because pulmonary embolisms result from blood clots forming elsewhere in the body, preventing a pulmonary embolism is predicated upon preventing the formation of blood clots.
Formation of a blood clot is largely out of a person’s control. However, there are a few key things that one can do to help prevent one from forming, such as avoiding prolonged periods of sitting or lying down.
Smoking cessation is also advised, as smoking promotes the formation of blood clots. Losing as little as 15 pounds can significantly reduce the risk of development. Finally, take measures to manage high blood pressure and diabetes, as these conditions can place unwanted stress on blood vessels and promote blood clot formation.
A pulmonary embolism can be extremely detrimental to a person’s health, if not deadly. If you are exhibiting symptoms, you should seek medical attention immediately to avoid complications.
However, through these methods, the spreading of blood clots to other parts of the body is easily preventable and manageable, and a pulmonary embolism doesn’t have to have a place in a vascular lifestyle.
Dr. Omar P. Haqqani is the chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.
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