Pulmonary Embolism

Pulmonary Embolism - What it is

Pulmonary embolism occurs when a blood clot occurs in the lung which results in a blockage of the blood supply to lungs. The blood clot can originate from the legs which may break off and travel through the blood stream to lodge in the lungs, causing severe damage to that organ. In other cases, it may start in the blood vessels of the lung.

Pulmonary Embolism - Symptoms

The symptom associated with pumonary embolism varies and is dependent on the location and size of the clot.

Common symptoms include:

Shortness of Breath
Chest Pain
Palpitations or irregular heart beat
Dizziness or fainting spells
Fever

Pulmonary Embolism - How to prevent?

Maintain a healthy lifestyle, stop smoking, exercise regularly, and prevent obesity. In situations of high DVT risks such as major surgery, do discuss with your doctor on preventive measures which include medications such as blood thinners and physical methods such as foot/calf pumps and compression stockings.

If the occurrence of DVT or PE is suspected it is best to seek medical help and to confirm the presence of DVT with radiological imaging such as a duplex ultrasound of the affected leg.

Pulmonary Embolism - Causes and Risk Factors

Risk factors for pulmonary embolism is similar to deep vein thrombosis. This includes poor blood flow and hypercoagulable states (a condition in which there is an abnormal increased tendency toward blood clotting). Conditions that put patients at high risk for DVT include spinal cord injury, major trauma, major general surgery. The use of chemotherapy, oral contraceptive therapy, hormone replacement therapy and paralytic stroke may also increase the risk of DVT. Other conditions that confer risks include obesity, bed rest for more than three days, and immobility due to sitting and varicose veins.

Pulmonary Embolism - Diagnosis

Pulmonary embolism is diagnosed via a computed tomography pulmonary angiogram which involves the injection of a dye into the blood vessel before the scan is taken. The scan will be able to identify any blood clots or blockages in the lungs. The scan may not be suitable for everyone such as people with poor kidney function or who are allergic to contrast dye.

Pulmonary Embolism - Treatments

The cornerstone in the treatment of pulmonary embolism is the use of medications called anticoagulants or “blood thinners”. Such medications slow down the formation of blood clots to allow the body’s natural system to remove the clots.

In severe pulmonary embolism where it is necessary to clear the blood clot quickly to re-establish blood flow for oxygenation of blood, thrombolytic therapy such as a tissue plasminogen activator (tPA), which is a clot dissolving enzyme may be used. Surgical or catheter directed procedures are sometimes used to clear the clot in the lungs. At SGH we have a pulmonary embolism response team which consist of different specialist who come together to manage patients who may be seriously ill.

The main complication of treatment with anticoagulation medications is bleeding. It is important to have regular follow up consultations and necessary blood tests to prevent and reduce the bleeding risks. We have a well-established anticoagulation monitoring service for our patients on anticoagulation.