Pulmonary Embolism: Should we be aware of this dangerous condition?

Have you ever suddenly found it hard to breathe, felt a sharp pain in your chest when you took a deep breath? Or have you suddenly felt your heart beating faster, sweating, and feeling anxious for no reason? Although we often think of this as a heart attack, it can be something much different and potentially very dangerous. Today we are going to talk about one such serious, but life-saving condition called 'Pulmonary Embolism'.

Simply put, what is Pulmonary Embolism?

Pulmonary Embolism (PE) is a blood clot that forms in a blood vessel (vein) that supplies blood to your lungs. Now you may be wondering, "How does a blood clot form in the lungs?" The truth is, this blood clot doesn't form in the lungs. Most often, it forms elsewhere in our body, especially in the deep veins of our legs or arms. We call this Deep Vein Thrombosis (DVT).

Think of the blood vessels in your body as a network of roads. This blood clot that forms in your leg, like a car, travels along that road with the blood, goes through the heart, and finally gets stuck in a small blood vessel in the lungs. It's like a big car stuck on a small road.

When a blood clot becomes lodged in the lungs, three main things happen:

1. Blood flow to the lungs is restricted.

2. Oxygen levels in the lungs decrease.

3. Blood pressure increases in the blood vessels connected to the lungs.

But the good news is that if the disease is diagnosed in a timely manner and treated properly, this condition is rarely fatal.

What are the symptoms of this condition? Pay attention immediately!

The symptoms of a pulmonary embolism (PE) can vary from person to person. It depends on the size of the blood clot and the effects it has. Some people may not have any symptoms at all. However, most people will experience one or more symptoms.

The main and earliest symptoms are sudden shortness of breath and chest pain that increases with deep breathing or exertion.

If you have one or more of these symptoms, seek medical advice immediately. It is best to go to a hospital's Emergency Treatment Unit (ETU). Prompt treatment can greatly reduce the risk of death.

The table below shows the most common symptoms of this condition.

For some people, these symptoms may develop gradually over days or weeks. Symptoms become more severe over time. However, for some people, severe symptoms develop within minutes of the onset of the condition.

Why does this happen? What are the risk factors?

As I mentioned earlier, Pulmonary Embolism (PE) is caused by a blood clot (DVT) that forms elsewhere in the body, especially in the legs, breaking loose and getting stuck in the lungs. So, anything that can cause these blood clots to form can also cause PE.

Some main reasons:

• Keeping the body still for long periods of time: When you stay in bed after an operation, or when you stay in the same position during a long flight or bus ride, blood circulation in the legs can slow down and blood clots can form.
• Damage to veins: Accidents, fractures (especially of the hip, knee, or leg), and major surgery can damage veins and increase the risk of blood clots.
• Other medical conditions: Conditions such as heart failure, cancer, and stroke.
• Changes in blood clotting: Some people may have genetic blood clotting disorders. Also, this risk may be slightly increased in people who take birth control pills or hormone replacement therapy.

Below are some of the people who are at higher risk for this condition. If you have one or more of these risk factors, it is important to talk to your doctor about it.

• Having or having had a blood clot in the leg (Deep Vein Thrombosis - DVT).
• Undergoing surgery or being in bed for a long time.
• Smoking.
• Being over 60 years of age.
• Pregnancy or the first 6 weeks after childbirth.
• Having cancer.
• Use of hormonal medications such as birth control pills.
• Obesity - Body Mass Index (BMI) greater than 30.
• Having a family history of blood clots.
• Having other chronic diseases such as diabetes and heart disease.
• Having a long-term central venous catheter (a tube inserted into a vein in the arm or leg) to deliver things like saline.

How to diagnose the disease? (Diagnosis)

When you go to the hospital, the doctor will carefully examine your symptoms and risk factors. Then, they will order several tests to confirm the diagnosis.

How is it treated?

Treatment for PE is usually done in the hospital, as your condition needs to be closely monitored. The length of treatment depends on the severity of the blood clot.

The main treatment is to give medications that prevent blood clotting . We call these anticoagulants or blood thinners .

• Anticoagulant medications: These are given as injections or pills. You may need to take these medications for 3-6 months, or sometimes longer. Do not stop taking these medications for any reason unless your doctor tells you to.
• Thrombolytic Therapy: This is a treatment given in very serious, life-threatening cases. These drugs work by dissolving the blood clot quickly. They are given under close observation by doctors in the intensive care unit (ICU).
• Other methods: Sometimes, if medication is not enough, surgery or a catheter may be needed to remove the clot. Another method is to insert a Vena Cava Filter. This is used to filter and catch blood clots from the legs before they reach the lungs.
• Compression Stockings: Your doctor may advise you to wear these special types of stockings to maintain good blood circulation in your legs.

Can this situation be avoided?

Yes, it is possible to a large extent. The key here is to reduce the risk of blood clots.

• Be active: Exercise daily. If you sit for long periods of time (airplanes, bus rides, office work), get up and walk around at least once an hour, moving your legs and arms.
• Avoid tight clothing: Wearing tight clothing can restrict blood flow.
• Don't cross your legs: Avoid sitting with your legs crossed for long periods of time.
• Maintain a healthy weight.
• Avoid smoking completely.
• Drink plenty of water: Dehydration can cause blood to thicken.
• Be aware of your risk factors: If you have surgery, are pregnant, or have other risk factors, talk to your doctor about steps you can take to prevent blood clots.

You should start to feel better within a week of treatment. However, it can take months or even years for the clot to completely dissolve. During this time, it is important to follow your doctor's instructions carefully.