What is pulmonary embolism?
Pulmonary embolism (PE) means a sudden blocking of an artery of the lung with a blood clot that went from leg veins with thrombosis.
Clot that forms in a part of the body and circulates through the blood in the body is called the embol.
Thus, in most cases, the EP complicatia is deep vein thrombosis (DVT). Normally, blood flows from the heart towards the lungs, where the right load with oxygen, then returns to the heart.
Here is pumped through vessels called arteries towards tissues, where, after you succumb to oxygen, it will return to the heart through the other system, called veins.
Veins carry oxygen-poor blood now at heart right, pumped to the lungs where it is loaded again with oxygen.
This is also the way in which a blood clot formed in the deep veins of the legs, can get into the lungs.
This condition usually occurs because of ingrosarii blood clots that favor in the deep venous circulation. If you breathe hard, sweat abundantly or feeling a pain behind the sternum, go to the doctor immediately.
Causes that can lead to acute pulmonary trombemboliei are in general of blood hypercoagulable States (thickening of the blood).
They can occur in the following situations: congenital
Deficits of clotting factors Nephrotic Syndrome Cancer Burden Using oral contraceptives (great attention to fumatoarele who use oral contraceptives) diabetes File extended bed fitting devices gipsate in case of fractures post-operative condition studies have shown that in 90% of cases over the thrombi is deep venous thrombosis of lower limbs (baring the veins with a clot blood).
What are the causes of PE?
In 9 out of 10 cases is produced by an PE blood clot that has formed in the deep veins of the legs (the disease-causing deep venous thrombosis is called), where he, pieces of which can break and get into the lungs where the pulmonary circulation clogs.
Other rare causes of embolism are air bubbles, pieces of cancerous tumors or bone marrow, such as fractures of the femur. Who has the risk of making the PE?
People with high risk for making PE are those over age 60: years; the risk increases after that age, every 10 years plus.
People will suddenly have difficulty PE to inhale deeply, feel chest pain, cough, coughing up blood or even irregular heartbeat.
In some cases, however, the only symptoms are those of deep vein thrombosis (DVT): edema, pain or redness at the foot. Contact your doctor immediately if you have signs or symptoms of DVT or PE.
But it is possible that people with PE not to have any of the symptoms above, but just to feel a fear unexplained, to breathe more often, to sweat or feel the heart beating faster.
How does it manifest itself?
Once mobilized, can clot pulmonary artery trunk close, one of the arteries of the lung or pulmonary artery bifurcation to lie on. Most often, small and medium sized thrombi stop medium and small branches of the pulmonary artery. Stopping place of rennet is relative to his size.
Thus, pulmonary embolism is achieved massive or minimal. In rare cases, the clot is absorbed spontaneously disappeared in a few days. In most cases you must promptly intervened.
Clinic symptoms depends mostly on the size of emboligen and thrombus in consequence of the severity of lung damage and breakage. Due to pulmonary artery astuparii, increases the pressure in the “heart”, the place of departure of the pulmonary arteries. In this way you get to “straight heart” dilation.
How to treat pulmonary embolism?
The main goal of treatment is to stop increasing PE rennet from the lungs and to prevent the formation of other clots.
The treatment begins with:
Simultaneously with heparin anticoagulant that acts immediately, and begins to acenocumarol Act on 2-3 days. When acenocumarol starts to act, stop the heparin.
Pregnant women are treated with heparin only because acenocumarol is dangerous for the load (see “how to treat DVT?”) If you have a massive pulmonary embolism your doctor will indicate a more aggressive treatment, namely medicines called thrombolytics may, which can dissolve blood clots quickly.
They can cause serious bleeding, but that is why they are used only when life threatening embolism. Rarely you may need surgery to remove embolilor.
How can it be prevent PE?
Prevention of DVT prevention starts with EP. Need to know if you have DVT risk making and to take the necessary measures to avoid such risks (see “how to prevent deep venous thrombosis?”).
How is it known?
Clinically manifests as pulmonary Trombembolia through: pain localized retrosternal what shines at times towards neck and upper limbs Dyspnea (breathing weight) cyanosis (seeds and skin of) These symptoms are often accompanied by a feeling of imminent death.
Physical examination of a patient with pulmonary trombembolism reintroduces cyanosis, diaphoresis (sweating), hypotension, tachypnea (increased respiratory frequency) sinus tachycardia (increased heart rate) jugular turgor (pulsation of neck veins), fever, signs of deep venous thrombosis.
None of the signs is not mandatory. If you notice people close one of these symptoms must be IHT rushed to the hospital because the condition can lead to death.
These symptoms may notify other diseases: myocardial infarction angina acute pericarditis (heart SAC inflammation) acute bronchial asthma pneumopathies postherpetic intercostala, trauma with rib fracture.
The prognosis remains reserved for the patients in case of cardiac or bronhopulmonar attack.
Without treatment, most patients with massive pulmonary embolism die 30-60 in the first minutes.