2. WHAT IS PULMONARY THROMBOEMBOLISM?
• A pulmonary embolism is a blood clot
that blocks and stops blood flow to an
artery in the lung. In most cases, the
blood clot starts in a deep vein in the
leg and travels to the lung. Rarely, the
clot forms in a vein in another part of
the body. When a blood clot forms in
one or more of the deep veins in the
body, it's called a deep vein
thrombosis (DVT).
3. SYMPTOMS
• Pulmonary embolism symptoms can vary greatly,
depending on how much of your lung is involved,
the size of the clots, and whether you have
underlying lung or heart disease.
• Shortness of breath. This symptom usually
appears suddenly. Trouble catching your breath
happens even when resting and gets worse with
physical activity.
• Chest pain. You may feel like you're having a
heart attack. The pain is often sharp and felt
when you breathe in deeply. The pain can stop
you from being able to take a deep breath. You
also may feel it when you cough, bend or lean
over.
• Fainting. You may pass out if your heart rate or
blood pressure drops suddenly. This is called
syncope.
4. CAUSES
• A pulmonary embolism occurs when a clump of material, most often a blood clot, gets stuck in
an artery in the lungs, blocking the flow of blood. Blood clots most commonly come from the
deep veins of your legs, a condition known as deep vein thrombosis.
• In many cases, multiple clots are involved. The portions of lung served by each blocked artery
can't get blood and may die. This is known as a pulmonary infarction. This makes it more
difficult for your lungs to provide oxygen to the rest of your body.
• Occasionally, blockages in the blood vessels are caused by substances other than blood
clots, such as:
• Fat from the inside of a broken long bone
• Part of a tumour
• Air bubbles
5. RISK FACTORS
• Although anyone can develop
blood clots that result in a
pulmonary embolism, certain
factors can increase your risk.
History of blood clots
• You're at a higher risk if you
or any of your blood relatives,
such as a parent or sibling,
have had venous blood clots or
a pulmonary embolism in the
past.
6. OTHER RISK FACTOR
• Smoking. For reasons that aren't well understood, tobacco use increases the risk of blood
clots in some people, especially those who have other risk factors.
• Being overweight. Excess weight increases the risk of blood clots — particularly in people
with other risk factors.
• Supplemental estrogen. The estrogen in birth control pills and in hormone replacement
therapy can increase clotting factors in the blood, especially in those who smoke or are
overweight.
• Pregnancy. The weight of a baby pressing on veins in the pelvis can slow blood return from
the legs. Clots are more likely to form when blood slows or pools.
7. HOW IS P.E DIAGNOSED?
• A provider will use the following tests to make a PE diagnosis:
• Blood tests (including the D-dimer test).
• Computed tomography (CT) angiogram.
• Ultrasound of your leg. (This helps identify blood clots in people’s legs, or deep vein
thrombosis, which can move to the lungs and become a PE and cause more
damage.)
• A ventilation/perfusion (V/Q) scan, if you’re unable to get contrast for a CT scan.
(This is a nuclear scan that can detect clots in your lung.)
8. HOW TO PREVENT P.E
• Exercise regularly. If you can’t walk around, move your arms, legs and feet for a
few minutes every hour. If you know you’ll need to sit or stand for long periods,
wear compression stockings to encourage blood flow.
• Drink plenty of fluids, but limit alcohol and caffeine.
• Don’t use tobacco products.
• Avoid crossing your legs.
• Don’t wear tight-fitting clothing.
• Lose weight if you have overweight.
• Elevate your feet for 30 minutes twice a day.
• Talk to your provider about reducing your risk factors, especially if you or any of
your family members have had a blood clot.
9. TREATMENT
• Blood thinners or anticoagulants are the most
common treatment for a blood clot in the lung. It is
important to note that blood thinners won't dissolve
blood clots. In most cases, the hope is your
body will eventually dissolve the clot on its own.
• The treatment approach for acute PE should always
consists of three major components:
cardiopulmonary support, anticoagulation to prevent
extension and recurrence, and reperfusion of the
PA. Cardiopulmonary support should first be
initiated with methods such as supplemental
oxygen and inotropic agents.
