Is there a blood clot in the lungs? Let's learn exactly about Pulmonary Embolism (PE)!

Have you ever suddenly found yourself having trouble breathing and feeling a little scared when your chest hurts? You probably thought it was a heart attack. But did you know that there could be a more serious cause for these symptoms? That is a blood clot in a blood vessel leading to the lungs, a condition called Pulmonary Embolism (PE) . This is not as rare as you might think. So today, let's talk about this in detail, in a very simple way.

What is Pulmonary Embolism (PE)?

Simply put, a pulmonary embolism is a blood clot that forms in a blood vessel in your lungs. Do you know how this happens? A blood clot that forms somewhere else in your body, most often in a vein in your leg or arm , breaks free and travels through your bloodstream, eventually getting stuck in your lungs. Think of it like a blockage in a waterway.

What happens when a blood clot gets stuck in the lungs like this?

• Blood flow to the lungs is restricted.
• Oxygen levels in the lungs decrease.
• Blood pressure increases in the pulmonary arteries.

This is a medical emergency . If not treated quickly, a pulmonary embolism can cause damage to the heart or lungs, and sometimes even death. In fact, it is said that about 33% of people with pulmonary embolism die before they are diagnosed and treated. So you can see how serious this is, right?

However, if the disease is diagnosed and treated correctly and promptly, this condition is rarely fatal.

How common is this condition?

Now you might be wondering how common this (Pulmonary Embolism) is. In fact, this is one of the most common diseases of the heart and blood vessels seen all over the world. In fact, it is the third most common condition after heart attack and stroke. Just think, in a country like America alone, about 900,000 people get this (PE) condition every year. So this is not something we should ignore, right?

What are the symptoms of this?

The first symptoms of a pulmonary embolism are usually shortness of breath and chest pain . This pain may worsen when you exercise or take a deep breath.

If you have these symptoms, you should seek medical advice immediately. Pulmonary embolism is a serious condition, but it can be treated well. Early treatment can greatly reduce the risk of death.

Symptoms of pulmonary embolism can vary depending on the severity of the blood clot. Many people have symptoms, but some may not have any symptoms at all.

The main symptoms that can be seen are:

• Sudden shortness of breath - This can happen whether you are active or at rest.
• Rapid breathing.
• Wheezing is a whistling sound when breathing.
• Unexplained sharp pain in the chest, arm, back, shoulder, neck, or jaw . This pain can resemble symptoms of a heart attack and may worsen when you breathe.
• Cough - may come with bloody phlegm.
• Pale skin, sweating, blue skin.
• Rapid heartbeat (Pulse).
• Excessive sweating.
• In some cases, there may be restlessness, dizziness, fainting, or loss of consciousness.

How long can someone have this without symptoms?

Some people have very mild symptoms at first. These symptoms may develop gradually over days or weeks. Over time, the symptoms gradually increase and come to your attention. However, for others, symptoms may appear within minutes, even seconds, of a pulmonary embolism. So you need to be very careful about this.

What are the reasons for this?

Okay, now let's see how this (Pulmonary Embolism) occurs, that is, what are the causes of this. The main cause is a blood clot that forms in a vein elsewhere in the body, especially in the legs or arms, breaks off from there, travels through the bloodstream and gets stuck in the lungs. When blood clots form in places like the legs, we call it (Deep Vein Thrombosis) or (DVT) .

There are several main reasons why blood clots form:

• A collection or "pooling" of blood in one area of ​​the body (often an arm or leg). This usually happens after surgery, after a long stay in bed, or after a long journey (by car, train, plane). Think about it, when you sit in the same position for hours, the blood flow in your legs gets a little blocked, right? That's when the risk of blood clots increases.
• Damage to a blood vessel, for example, due to a fracture or surgery (especially of the hip, knee, or leg).
• Other medical conditions. For example, cardiovascular disease – conditions such as (Congestive heart failure), (Atrial fibrillation), heart attack or stroke.
• Changes in your blood clotting factors. These blood clotting factors may increase in some types of cancer, or in people taking hormone replacement therapy, or in some people taking birth control pills. Also, people with blood clotting disorders are at risk.

Who is at higher risk of developing this?

Now let's see who is more likely to develop this (Pulmonary Embolism), that is, who is at risk. There are certain habits, certain diseases, or certain situations that increase this risk.

• For those who have a blood clot in the leg, that is, Deep Vein Thrombosis (DVT).
• For those who are stationary for long periods of time, such as when traveling by car, train, or plane (e.g., a long cross-country car trip).
• Those who have recently had an injury or damage to a blood vessel due to surgery, a fracture, or a condition such as varicose veins.
• Those using hormone-based birth control methods (such as birth control pills, patches, rings) or hormone replacement therapy.
• For people with a blood clotting disorder.
• For those with a family history of blood clots.
• For those who currently smoke.
• For those with Diabetes Mellitus.
• For those suffering from cancer.
• For those over 60 years of age.
• For those with a history of heart failure, heart attack, or stroke.
• For those with a Body Mass Index (BMI) of over 25, that is, overweight, or for those with a BMI of over 30, that is, obese.
• For pregnant women or those within six weeks of giving birth.
• For those who have a central venous catheter inserted through a vein in the arm or leg.

If you have one or more of these risk factors, and you have had a blood clot before, it is very important to talk to your doctor and take steps to reduce your risk of PE.

What complications can this cause?

Pulmonary Embolism can cause complications such as:

• Cyanosis - This is the bluish discoloration of the skin, caused by a lack of oxygen.
• Heart attack.
• Stroke.
• Pulmonary hypertension - This means increased pressure in the blood vessels of the lungs.
• Shock.
• Pulmonary infarction - This is the death of lung tissue.

These are serious conditions that require prompt treatment for PE.

How do you diagnose this?

Okay, if you have symptoms like these, how does a doctor or a nurse diagnose pulmonary embolism? They look at your symptoms, your risk factors, and then they do a few tests.

• Blood tests - Among these , the D-dimer test is important.
• Computed tomography (CT) angiogram - This is a special CT scan that looks for blood clots in the blood vessels of the lungs.
• Ultrasound of the legs. - This is done to check for Deep Vein Thrombosis (DVT) in the legs. This is where a clot can travel to the lungs.
• VQ scan - If you cannot get the contrast material needed for a CT scan, this scan can detect blood clots in the lungs.
• Pulse oximeter (pulse ox) - A device that measures oxygen levels by attaching it to a finger like a clip.
• Echocardiogram - An ultrasound examination of the heart.

In addition to this, other tests can be performed:

• Pulmonary angiogram.
• Chest X-ray.

How to treat?

This (Pulmonary Embolism) is a medical emergency. It is usually treated in a hospital. Your condition can then be closely monitored. The length of time you stay in the hospital depends on the severity of the blood clot. There are times when some people may not need to stay in the hospital.

The main treatment for pulmonary embolism is blood-thinning medications called anticoagulants .

Depending on the severity of the blood clot and its impact on other organs, such as your heart, you may be treated with thrombolytic therapy (blood clot-dissolving treatment), surgery, or other interventional procedures to improve blood flow in the blood vessels of the lungs.

Anticoagulant drugs

In many cases, the treatment is given as anticoagulant drugs, that is, blood thinners . These drugs work by reducing the ability of your blood to clot. This prevents new blood clots from forming and stops existing clots from getting bigger.

As with any medication, it is very important to know exactly how and when to take this (anticoagulant) medication, and to follow your doctor's instructions. The type of medication you are given, how long you need to take it, and what follow-up tests you need to have will depend on your diagnosis. So it is important to go to your doctor and lab every day. That way, they can see how you are responding to the medication. While taking (anticoagulant), you will also need to have regular blood tests (such as a prothrombin time test ) to see how quickly your blood clots.

Compression stockings

These are a special type of socks. These socks improve blood circulation in the legs. You may have seen people with Deep Vein Thrombosis (DVT) using these. You should use these as prescribed by your doctor. These are usually knee-length socks. They help to keep your legs tight and prevent blood from pooling. Ask your doctor about how to use these socks, how long to wear them, and how to wash and keep them clean.

Other treatments (Procedures)

If the pulmonary embolism is life-threatening or if other treatments have not worked, your doctor may recommend surgery or a catheter to remove the blood clot from the pulmonary artery. Thrombolytic therapy is another option. This involves giving you medications that "dissolve" blood clots . An example is a drug called Tissue Plasminogen Activator (TPA) . This medication is given in a hospital's emergency department or intensive care unit (ICU) and you are closely monitored. This treatment may be given if your blood pressure is low or if your condition is unstable due to the pulmonary embolism.

Sometimes, your doctor may recommend a vena cava filter . This is a kind of filter that is inserted into the largest vein in the body. When this is inserted, blood clots are trapped in this filter before they can travel to the lungs.

Side effects of treatment

Bleeding is one of the main side effects of the medications used to treat pulmonary embolism. That's why doctors will give you the right dose of anticoagulant or thrombolytic for your condition. It's also easier for them to monitor your condition while you're in the hospital.

How quickly will I recover after treatment?

You will start to feel better within about a week of starting treatment. However, it can take months, even years, to fully recover from a pulmonary embolism.

Because when the blood vessels in the lungs become blocked, the heart has to work harder to pump blood. Just like a clogged water pipe makes a motor feel more strain. For this reason, after a PE, it takes months for one of the chambers of the heart to return to normal. This can make it difficult for them to work as hard as they used to.

Can this be prevented? (Prevention)

Yes, you can help prevent this to a large extent. To prevent a pulmonary embolism, do these things:

• Exercise regularly. If you can't walk, move your arms, legs, and feet for a few minutes every hour. If you know you'll be sitting or standing for long periods of time, wear compression stockings to improve circulation.
• Drink plenty of water, but limit alcohol and caffeine.
• Do not use tobacco products.
• Don't cross your legs.
• Don't wear tight clothes.
• Maintain a healthy weight for you.
• Keep your legs elevated for about 30 minutes twice a day.
• Talk to your doctor about reducing your risk factors, especially if you or someone in your family has had a blood clot before.
• Talk to your doctor about a (Vena cava filter).

What can you expect if you have a PE?

If left untreated, pulmonary embolism is a very serious condition that can cause permanent disability or death. Some people die immediately after a pulmonary embolism, or within a few hours. This can happen before a doctor can even diagnose the condition.

If you have heart or lung disease, you are at higher risk of dying from a PE. However, due to improved imaging methods, a pulmonary embolism is only fatal in 1% to 3% of people.

With treatment, your prognosis depends on the size of the blood clot, the blockage, your overall health, and how well your heart can pump blood.

Will PE go away completely?

It can take months, even years, for a pulmonary embolism to completely resolve. Sometimes, repeated PEs can lead to a chronic condition called chronic thromboembolic pulmonary hypertension (CTEPH) .

How do I take care of myself?

You will need to take blood thinners for three to six months, or even longer. Do not stop taking them until your doctor tells you to. While taking blood thinners, be as careful as possible about activities that could cause you to get injured and bleed.

Talk to your doctor about your follow-up care and follow their advice to reduce your risk of having another PE. They may suggest things like quitting smoking, getting more exercise, and changing your eating habits.

Go to every appointment with the doctor and the lab to see how you are responding to the prescribed treatments.

If you feel anxious or scared after a PE, ask your doctor to talk to a counselor. It will help you.

When should you see a doctor?

See your doctor for follow-up appointments. Tell your doctor if your stools are black, you have a severe headache, or you have a bruise that gets bigger while taking blood thinners. These could be signs of internal bleeding.

When should you go to the Emergency Treatment Unit (ETU) ?

If you have the symptoms of Pulmonary Embolism (mentioned earlier), seek treatment immediately. Don't delay.

What questions should I ask the doctor?

Here are some questions you might want to ask your doctor:

• What is the best treatment for me?
• How long do I need to take the medicine you prescribed?
• When is my next follow-up test?

After a pulmonary embolism, you may find that your life will never be the same again. It's important to accept that. Others may not understand that you're afraid of having it happen again. So it can be helpful to talk about your fears with a support group or counselor. Fight your fears and continue to follow your doctor's instructions, including taking the medications they prescribe.

Take-Home Message

Pulmonary Embolism is a very serious, potentially life-threatening condition that can occur suddenly. However, if you recognize the symptoms quickly and seek immediate medical attention, you can make a full recovery. Therefore, if you experience symptoms such as shortness of breath and chest pain, do not take it lightly. See a doctor immediately. It is also very important for those with risk factors to try to reduce them. Your health is in your hands!

` Pulmonary Embolism, PE, Lung Blood Clot, Shortness of Breath, Chest Pain, DVT, Blood Clots, Blood Thinning Medications, Anticoagulants