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.
Platelets
Platelets or thrombocytes are cell fragments found in the blood with an average life span of about 5- 9 days. Typically a healthy adult has about 150,000 to 450,000 platelets per micro liter of blood. Platelets are crucial for the clotting process since they are involved in hemostatis. If the platelet count is too high or low, it can be indicative of some disorders. Abnormally high platelet count can lead to myocardial infarction, pulmonary embolism or a stroke. Very low platelet count can lead to excessive bleeding. Low platelets can happen due to medications, leukemia, hemolytic anemia or chemotherapy. Abnormally high platelet count can be due to anemia, thrombocythemia or recent spleen removal.
Chest x ray
Chest x-ray is a regular diagnostic test that throws light on the condition of the lungs, heart and chest wall. Chest x-ray reveals possible lung cancer, emphysema, heart failure and pnemonia. Heart irregularities and CHF may be visible on a chest x-ray. Any pleural effusions may be detected through a chest x-ray. The patient must wear loose fitting gown and remove any metal objects from clothing. In most cases, chest x-ray of frontal or posteroanterior view is taken. The patient has to take a deep breath so as to ensure a good quality chest x-ray image. There is no discomfort. Pregnant women must not undergo chest x-ray. But some conditions may not be easily diagnosed with a chest xray, such as pulmonary embolism or some cancers. In such cases, CT scan of chest is used for further clarification. Abnormal findings on chest xrays can range from pnemonia and tuberculosis to lung tumor or collapsed lung. Osteoporosis or fracture of ribs or spine can be detected.
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