Did you know that heart disease is the leading cause of death globally? On 11 November 2023, Asian Heart & Vascular Centre held Heart to Heart Talk 2023, organized by MediaCorp, official media partner, CNA, at Suntec Convention Centre. We hope to bring awareness and get everyone to recognize the symptoms of common heart and related diseases, and understand the treatments available. Here's the presentation shared by Dr Pipin Kojodjojo. Dr Pipin Kojodjojo specializes in cardiac electrophysiology and the management of heart rhythm disorders in both adolescents and adults. He is experienced in managing patients with atrial fibrillation and unexplained blackouts (syncope). For more info, visit www.ahvc.com.sg

1. Pulmonary Embolism
No. 1 Cause of Preventable Hospital Death Worldwide
What is it?
Dr Pipin Kojodjojo (许丕评医生)
Cardiologist, Asian Heart and Vascular Centre

2. Our Circulation – Figure of 8

3. What is a pulmonary embolism (PE)?
• A large blood clot forms in
the veins of the leg
• Travels up the body,
through the heart
• Blocks blood supply to the
lungs and stops the
circulation
3

4. Blood clots from the leg
Removed from patient before it got into the lungs

5. Impact of Pulmonary Embolism
5
Normal
PE patient
Symptoms
• Breathlessness
• Faints / blackouts
• Chest pain
• Cardiac arrest
• Coughing
• Blood in sputum
• Painful, swollen calf

6. Pulmonary Embolism Statistics
• 10 million cases of PE and DVT (deep vein thrombosis) diagnosed each year
• 100,000 deaths from PE in the USA (1 million cases in total) – more than HIV, breast cancer
and road traffic accidents added together – 1 death every 6 minutes from PE
• 30% mortality (within 30 days if untreated), 11% of patients die in the first hour
• Third most common cardiovascular death globally after heart attack, stroke
• 50% of people have never heard of the term pulmonary embolism and 81% of people
would not know what a PE would feel like if they experienced one
6

7. Who’s at risk for pulmonary embolism?
• Cancers
• Heart Disease
• Surgery / injury to hips and
knees
• Smoking
• Prolonged immobility / long
trips
• Recent COVID-19 infection (as
high as 25% of severe COVID
patients in ICU)
• Overweight
• Medications
• Pregnancy
7

8. Conventional treatment for PE over 20 years
• Give blood thinners (anticoagulants) and monitor
• Patients are hospitalized for at least 1 week
8
Diagnosed with PE
- Blood thinners
given
Continue
monitoring
Is the patient at risk
of a cardiac arrest?
NO
Give large dose of
clot-busting drug
(thrombolysis)
YES
11.5% - major bleeding
2.0% - bleeding stroke
30% - failure to clear the clots

9. Limited progress in treating PE for the past 20 years
• Survival from PE has hardly changed in the past 2 decades, with incomplete
recovery in 50% of patients
9
US Deaths from PE

10. There is better way to manage pulmonary embolism!
• Remove the blood clots in lung with a minimally invasive procedure that
carries very low risk
• Complete resolution of symptoms
• Discharge within 24 hours and back to normal life
• No long term effects of PE – continued breathlessness, fatigue
• Reduce death from PE – 30% down to 1.5%
10

11. Catheter Suction Thrombectomy
11

12. All blood clots (PE) removed from the
lungs in the past 10 days