pulmonary embolism treatment

What is Pulmonary Embolism?

Pulmonary embolism is a blood clot in one of the pulmonary arteries or arteries present in the lungs. Most often, these are caused by deep vein thrombosis, which means that blood clots travel to the lungs from deep veins in the legs or from veins in other parts of the body. Pulmonary Embolism Treatment depends on the size of the clot.

Pulmonary embolism is a life-threatening and serious problem that needs immediate attention. According to research by WebMD, about a third of people who are undiagnosed and untreated pulmonary embolism do not survive.

Since the clots are blocking blood flow to the lungs, a prompt treatment(Pulmonary embolism treatment) to unclog the arteries can reduce the risk of death. Also taking measures early on to prevent blood clots in the deep veins of legs can help protect against pulmonary embolism.

Causes of Pulmonary Embolism

Pulmonary embolism occurs due to a clot caused by a clump of material mostly blood clumps that get into the arteries in the lungs. Occasionally the clump of material can also be substances like fat from marrow, part of a tumor, or even just air bubbles. In a lot of cases, the embolisms are blood clots found to be coming from the deep veins of the leg, a condition called deep vein thrombosis or DVT.

Multiple clots can also be possible in pulmonary embolism. As a result, the portions of the lung that need to be getting the blood may die as they are now devoid of blood flow due to the blocked artery. This condition is known as pulmonary infarction. Pulmonary infarction makes the lungs difficult to perform their duty of providing oxygen to the rest of the body.

Pulmonary embolism Symptoms

Symptoms of pulmonary embolism can vary depending on the size of the clots, the percentage of the lung affected by the clot, and whether there are other lungs or heart diseases. Some common signs include:

  1. Shortness of breath: Typically appears suddenly and can get worse with exertion.
  2. Chest pain: A sharp pain in the chest especially while breathing making it impossible to take deep breaths.
  3. Cough: cough can be accompanied by blood or blood-streaked sputum sometimes.
  4. Rapid or irregular heartbeat
  5. Dizziness or lightheadedness
  6. Excessive sweating
  7. Fever
  8. Deep vein thrombosis shows signs of Leg pain or calf swelling
  9. Discolored skin also called as cyanosis

Pulmonary Embolism Risk Factors

  1. Prior Medical conditions and undergoing treatments can put you at risk of Pulmonary Embolism
    1. Heart disease
    2. Cancer
    3. Surgery
    4. Inherited disorders affecting or making more prone to clotting
    5. Coronavirus disease (COVID-19)
  2. Prolonged immobility – Blood clots are more likely during periods of inactivity like bed rest or long trips.
  3. Smoking Tobacco use can predispose people to blood clot formation.
  4. Being overweight
  5. Birth control pills or hormone replacement therapy
  6. Pregnancy. Baby weight puts pressure on the pelvis veins and slows the blood returning from the legs putting at risk of forming clots.

Other Complications

  • Pulmonary heart hypertension: Pulmonary embolism can lead to hypertension in which condition the blood pressure in the lungs and on the right side of the heart is too high. This happens because pulmonary embolism is obstructing the arteries inside the lungs due to which the heart is working harder to push blood through those vessels resulting in increased blood pressure and weakening of the heart.
  • Chronic thromboembolic pulmonary hypertension: If the emboli are small and occur frequently then they develop over time resulting in chronic pulmonary hypertension. This condition is also known as chronic thromboembolic pulmonary hypertension.

Pulmonary embolism Treatments

Treatments for pulmonary embolism can be started in the hospital or even in the ER and you can be discharged the same day. How long you’ll stay and be treated depends on your condition.

1. Anticoagulants or Blood Thinners

Anticoagulants though do not dissolve blood clots, they keep them from growing bigger and also stop new clots from forming. This is the most common treatment used for blood clots in the lung.

The most commonly prescribed blood thinners are can be got through a shot or an IV. Some of the blood thinners are also given in pill form. A doctor can decide which agent can work best in the particular situation of the patient.

Doctors may keep a close eye on the patient after giving blood thinners so there are no risks that can happen if the medicine thins the blood too much.

2. Thrombolytics

Sometimes the symptoms of deep vein thrombosis (DVT) or pulmonary embolism (PE) can be very severe and more aggressive treatments are needed. Thrombolytics are medications that can rapidly dissolve blood clots. Thrombolysis is used in only selected patients with severe pulmonary embolism and if extensive blood clots in the lung are resulting in acute heart failures or acute lung failures. Thrombolysis is done by specialists in a hospital setting with close observation throughout the time of delivery and treatment to avoid any risk of potential internal bleeding.

3. A catheter or Percutaneous thrombectomy

In a few cases, as an emergency treatment doctors might recommend the removal of clots using a catheter. A catheter is a thin, flexible tube that is inserted into a vein through the thigh or arm and continued to the lung to remove the clot or to dissolve it with medicine.

4. Inferior vena cava (IVC) filter.

An inferior vena cava filter can stop clots from getting into the lungs from the lower body. The inferior vena cava is the large vein that carries blood from the lower body part of the body to the heart. A doctor needs to put a filter in the inferior vena cava stop clots before they get to the lungs. This filter cannot stop new clots from forming.

5. Pulmonary Embolectomy Surgery. 

In a few rare cases, the doctor may also suggest surgery to remove a clot from the lung. Performed only in cases when the clots are too large and anticoagulation or thrombolytic therapies could not work for the patient’s condition.

Prevention and Recovery from Pulmonary Embolism

Prevention of clots in deep veins of legs and the travel of the clots into the lung can prevent pulmonary embolism. For this reason, the following measures can be taken to prevent DVTs and blood clots:

  • Blood thinners (anticoagulants). Only for patients with medical conditions such as heart attack, stroke or cancer are prescribed blood thinners as they are at risk of clots before or after treatments
  • Compression stockings. Compression stockings or support hose steadily squeeze the legs, helping blood flow more efficiently in the leg muscles and veins. They are the safest and inexpensive way to keep blood from stagnating and forming into a clot.
  • Leg elevation. Elevation of legs during the night by at least 4 to 6 inches can be very effective to increase blood flow in the lower part of the body to stop the pooling of blood.
  • Physical activity. Always being on the move as much as possible can help prevent pulmonary embolism. People who have jobs where they are traveling long hours or in sitting or standing positions for long hours at work need to find a way to keep fidgeting and moving for the blood to flow more efficiently.
  • Pneumatic compression. Treatment where massage cuffs are used to automatically inflate and deflate air every few minutes to squeeze the veins in the legs to improve blood flow.
  • Drink plenty of fluids. Drinking plenty of liquids to keep the body hydrated can help in de coagulation of blood which is made of a large percentage of water. Drinking water regularly is the best and most simple way to prevent dehydration and in turn improve the flow of blood.

Pulmonary embolism treatment in India

Pulmonary embolism treatments need to be taken seriously as they can be fatal if not attended to on time. Early prevention of DVTs or blood clots is the best way to stop the disease before it can impede with lifestyles. A specialist in the lung, heart, or both heart and lung diseases can be approached in case of any symptom to get treated properly. Since pulmonary embolisms can vary, its treatment also varies with the size of embolism, cause, risk factors, and patients’ medical condition.

To get a good idea about Pulmonary Embolism treatments in India, check out the treatment conditions and the best doctors who have had experience treating such cases. Dr. PV Naresh is an acclaimed Cardiothoracic Surgeon who has experience of over 20 years in treating patients with cardiothoracic problems.

He is a full time cardiothoracic and transplant surgeon at Yashoda Hospitals in Hyderabad. He has successfully performed surgeries in CTVS and Off-Pump CABG Total Arterial Revascularization, Minimal Invasive Valve Surgery, MIDCAB, Aortic Aneurysm Repairs, and the Minimal Invasive Valve Repairs and Replacements.

Dr. PV NAresh Kumar is known for performing many Lung and heart transplants. Dr.Naresh is the best person to consult with any problems with pulmonary embolism and treatments in Hyderabad as he can give a holistic opinion of the problem taking into account both heart and lung organs of the thoracic region. Please visit his website at https://doctorpvnaresh.com/ or book an appointment to meet with him in person to clarify any queries.

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