Pulmonary Embolism

What is pulmonary embolism?

  • Pulmonary embolism (PE) is a blockage of blood vessels supplying the lungs (pulmonary artery) due to blood clot.
  • These blood clots arise from deep veins of lower leg or thigh or arm (Deep vein thrombosis aka DVT).
  • This leads to decreased blood flow to the lungs, decreased oxygen levels that can potentially be dangerous and life-threatening.
Pulmonary Embolism
Pulmonary Embolism

What are the consequences of pulmonary embolism?

  • Most PE cases are not diagnosed, hence not treated.
  • DVT precedes PE which itself may not be diagnosed. Symptomatic DVT presents with the swollen limb.
  • DVT can lead to PE and consequent death in up to 70% of cases.

What are the causes of pulmonary embolism?

  • Deep vein thrombosis
  • Cancer
  • Air bubbles in the lungs
  • Fat from the bone injuries or fracture

What increases the risk of developing pulmonary embolism?

  • Recent surgeries of the spinal cord, hip or knee
  • DVT
  • Carcinoma treated with chemotherapy
  • Chronic lung or cardiac disease(Heart failure)
  • Blood clotting disorder
  • Brain stroke
  • History of venous catheterization
  • Prolonged immobility due to patient who is older age, bedridden, recent major surgery or intensive care unit.
  • Medications containing estrogen-like Oral contraceptive pills and hormone replacement therapy
  • Obesity
  • Pregnant and lactating women
  • Smoking
Pulmonary Embolism CT 1
Pulmonary Embolism CT 2
Pulmonary Embolism CT 3
Pulmonary Embolism CT 4

What are the symptoms of pulmonary embolism?

  • Breathlessness
  • Palpitations
  • Chest pain or discomfort
  • Giddiness and sudden loss of consciousness
  • Coughing up blood

What are the complications of pulmonary embolism?

  • Despite modern therapies for 8-10% affected by pulmonary embolism die.
  • Pulmonary hypertension: Increased blood pressure in the lungs and right side of the heart.
  • In rare conditions, fragmented blood clots get deeply deposited in medium to small-sized blood vessels leading to chronic thromboembolic pulmonary hypertension (CTEPH).

How is pulmonary embolism diagnosed?

  • CT pulmonary angiogram: Definitive test that identifies blood clots in pulmonary arteries as well as the severity of the problem.
  • Electrocardiogram
  • Echocardiogram
  • Venous duplex ultrasound: the test is to identify blood clots in the deep vein
  • Blood tests: D-Dimer test
  • Chest X-ray
  • Medical history
  • Physical examination

How is pulmonary embolism prevented?

Non-pharmacological treatment:

  • Drink plenty of water
  • Avoid standing/sitting for a long duration
  • Maintain a healthy weight
  • Use compression stockings to prevent DVT (Deep vein thrombosis)
  • Quit smoking
  • Regular exercise
  • Do not take over the counter drugs without suggestion from your doctor. 

Pharmacological treatment:

  • Anticoagulation therapy (Heparin, warfarin, enoxaparin or fondaparinux) is the first-line treatment for acute PE to dissolve the clot.
  • Although anticoagulants are the first-line therapy for PE, some patients may get benefit from added therapy like clot-buster drugs (thrombolysis or fibrinolysis) if they fulfil the following criteria

1) Evidence of moderate to severe right ventricle injury

2) Evidence of respiratory or circulatory insufficiency in PE patients

  • Thrombolytic agents (streptokinase, urokinase, tissue plasminogen activator) prescribed for breaking the clots through a catheter (Catheter-directed thrombolysis).
  • Thrombus aspiration using Penumbra technology.
  • Embolectomy: This surgery used a flexible tube to remove embolus in the artery or vein.

What is the uniqueness of treatment of pulmonary embolism by Dr C Raghu?

Dr Raghu and team use new technology, Penumbra, for thrombus aspiration after identifying the location and size of the thrombus and remove the clot with higher success rate and symptoms improve.





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Copyright © 2019, Dr C Raghu. All rights reserved.
Designed & Developed by R R Deepak Kambhampati.

Copyright © 2019, Dr C Raghu. All rights reserved.
Designed & Developed by R R Deepak Kambhampati.

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