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Pulmonary Embolism

When an artery in the lungs gets blocked, it is referred to as a medical condition of Pulmonary embolism. This condition can be life threatening. Often deep vein thrombosis(DVT) can lead to pulmonary embolism. The blood clots may originate in any other part of the body such as the arm, pelvis or legs. These clots travel through the bloodstream and enter the pulmonary arteries. Recent surgery or injury can lead to a blood clots. Persons with heart disease or those on estrogen therapy are at increased risk of pulmonary embolism. Typical symptoms experienced by those suffering from pulmonary embolism are chest pain, sudden shortness of breath and rapid heartbeat. A patient might have wheezing and weak pulse. The symptoms of pulmonary embolism depend on the extent and size of clots. Embolus can also be the result of fat from the bone marrow that has escaped into the bloodstream. It can also occur due to air bubbles formed during intravenous infusion or surgery. While large emboli cause considerable distress such as chest pain, smaller ones cause shortness of breath. Patients suffering from pulmonary embolism tend to have cough that produces sputum. There may be bluish discolaration on the skin and pain in the legs. Fainting spells or seizures might occur due to sudden decrease in oxygen-rich blood to the brain and other organs. Bluish tint on the skin (cyanosis) is observed when one or more large pulmonary arteries are obstructed.


Diagnostic procedures to detect pulmonary embolism:

  • Chest X-ray helps in identifying any lung infections
  • CAT scan
  • ECG
  • Perfusion Scan of the lung - This test helps in outlining the blood flow to the lungs and helps in detecting any obstructions.
  • V/Q scan involves a a nuclear ventilation-perfusion study of the lungs.
  • Pulmonary angiogram involves injection of a special dye into the pulmonary arteries to detect obstructive clots.
  • D-dimer test is a test that spots d-dimer molecules released by the clots.

One of the initial steps to help a person suffering from pulmonary embolism is administration of oxygen and analgesics. Oxygen is administered through a nasal cannulae or face mask. Blood clots are treated with anticoagulant drugs like heparin or warfarin. But the duration and dosage of anticoagulants needs to be monitored so that it does not result in bleeding in other body organs. Thrombolysis is a procedure whereby thromoblytic agents (clot-dissolving agents) are injected into the bloodstream to dissolve existing blood clots. Surgery (Pulmonary embolectomy) is often resorted to for removal of clots.

Thrombophlebitis

Thrombophlebitis is derived from the word 'thrombo' which means clot. Phlebitis indicates a swollen or inflammed vein. Thrombophlebitis is a blood circulatory condition that is caused by blood clots. It occurs mostly in the legs. Thrombophlebitis can occur at a superficial or deeper level. Superficial thromboplebitis occurs more commonly and is seldom life threatening. On the other hand, deep venous thrombosis affects larger and deeper veins. Sometimes there may be a condition of both superficial and deep vein components. In cases where there is superficial thromboplebitis, care must be taken to ensure that it does not cascade into condition where the deep veins are involved. Most cases of superficial thrombophlebitis resolve by themselves in a couple of weeks. It is when the deeper veins are affected that the clot can hamper or even cut off the bloodstreem. The clot can travel through the blood and block circulation in vital organs such as the heart or lungs.


One of the common causes for thrombophlebitis is hospitalization due to surgery or bedrest. This is because thrombophlebitis is caused from long periods of inactivity. Long airplane journeys can reduce blood flow through the veins and lead to the formation of clots. Varicose veins, pregnancy or complication of IV tubes can lead to thrombophlebitis. Women using oral contraceptives or undergoing HRT are at increased risk of developing thrombophlebitis. If you have a family history of blood clots, you may be at risk of thrombophlebitis. When a patient suffers from thrombophlebitis, the leg veins become swollen and hard to touch. There is redness and swelling in the affected area. When a person suffers from superficial thrombophlebitis, he/she might feel a hard and tender cord barely under the surface of the skin.


Diagnostic tools such as Doppler ultrasound or blood coagulation studies help in examining a patient for thrombophlebitis. For mild cases of superficial thrombophlebitis, you can take analgesics to reduce pain and nonsteroidal anti-inflammatory drugs for inflammation. To reduce the pain or discomfort and the swelling, support stockings and elevation of the affected extremity are usually recommended. In cases of deep venous thrombophlebitis, thrombolytic drugs are prescribed to melt the clots. Antibiotics are prescribed to treat any infection. Supportive hose or stockings can help in reducing swelling. Keeping the leg elevated prevents excess fluid in the affected area. Application of moist heat on the affected area helps in reducing pain. In high-risk cases of deep venous thrombophlebitis, surgery is used to strip out the affected vein or bypass the clot. Anticoagulants or blood thinners to prevent new clots from forming.

Blood Clotting

Blood clotting occurs due to a complex process of coagulation that heals a bleeding blood vessel with at clot. Blood platelets and plasma protein fibrinogen are vital to the blood clotting process. People can suffer from various blood clotting disorders such as formation of blood clots due to excessive blood clotting. The PT or Prothrombin Time Blood Test is done before any surgery to check a patient's bleeding and clotting factors. PTT or Partial Thromboplastin Time Blood Test checks for a clotting disorder.


Blood clots

Blood clots can form in the heart or legs or brain or even in the lungs. These clots can travel through the blood vessels and hamper the flow of blood. This can lead to damage in the organs. Blood clot in the veins of the arm or legs can lead to DVT or deep vein thrombosis. Pulmonary embolism is a condition where a blood clot travels to the lungs. Blood clots during pregnancy can lead to miscarriage or pre eclampsia.

Excessive bleeding

Bleeding disorders can occur due to severe liver disease. Hemophilia is an inherited bleeding disorder. Bleeding disorders can also be a side effect of medicines.



Bibliography / Reference

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