Pulmonary embolism (PE) is a life-threatening medical condition resulting from dislodged thrombi occluding the pulmonary vasculature. In simpler terms, it is a blockage in one of the pulmonary arteries that supplies oxygen-rich blood to the lungs. It is a thrombotic disorder. It occurs when a blood clot breaks loose (usually from the leg, aka, deep vein thrombosis), and travels through the bloodstream of the lungs. When not treated aggressively and appropriately, it may result in:

 

  • Right heart failure and cardiac arrest
  • Permanent damage to the lungs
  • Damage of other organs due to the non-supply of enough oxygen-rich blood

Who is at risk for PE?

Although PE can occur in anyone, persons with the following characteristics are at greater risk of developing PE:

 

  • Family history of blood clots, PE or DVT and certain genetics changes
  • Medical conditions such as blood clotting disorder, cancer, heart disease and lung disease
  • Recent surgery (within the last 2 months) or hospitalisation
  • Pregnancy and childbirth at about 6 weeks
  • Increasing age especially over 60
  • Long flights
  • Immobility
  • Obesity
  • Estrogen supplements
  • Inflammatory bowel disease

 

Are there symptoms associated with PE?

Most people with PE develop no symptoms, however, common symptoms amongst those who have include:

 

  • Coughing up blood or coughing up brown substance
  • Breathlessness
  • Rapid breathing
  • Chest pain: a sharp stabbing pain when you breathe in
  • Inability to lift your breast on the affected side
  • DVT
  • Rapid or irregular heart rate
  • Fainting
  • Low blood pressure
  • Dizziness

 

Diagnosis

PE can be diagnosed via various medical investigations such as ECG, Chest x-ray, D-Dimer, CT scan, MRI, Pulmonary Angiogram, EKG, Doppler,  and so on. The investigations are ordered and done based on the advice of the cardiologist examining the patient.

 

Treatment

Patients that have been diagnosed with PE require immediate treatment with the goal to break up the clots and keep other clots from forming. Varying treatments accompany different patients and varying degrees of PE alongside other medical conditions such as low blood pressure. For example, these treatments may involve the use of medications such as anticoagulants and/or catheter-assisted thrombus removal procedure, and/or the use of anti-embolism compression stockings. Nevertheless, our overall goal is to stop the clot from growing, prevent new ones and destroy existing ones.

 

With timely treatment, most patients with PE make full recovery and are able to live their lives as normal. Nevertheless, the condition still has a very high risk of fatality hence the importance of early treatment.

 

In order to minimise the risk of PE, it is important to include physical activity into your routine, a healthy diet, and quit smoking. When travelling by flight or road, take 2 hour breaks to stretch and walk around.