PVD-Pulmonary Embolism

Pulmonary embolism occurs when a blood clot (embolus) suddenly breaks loose from where it formed in a peripheral vein and travels through the body to the arteries of the lungs. Damage can be caused by a large clot or a series of smaller clots. Pulmonary embolism is an extremely serious condition that can lead to low blood oxygen levels, permanent lung damage, organ damage, and sudden death.

Who is at Risk for Pulmonary Embolism?
Risk factors for pulmonary embolism include:

• Recent surgery
• A long period of immobility (e.g., prolonged illness or bed rest)
• Cancer or heart problems
• Older age
• Taking oral contraceptives
• A previous stroke or heart attack

Symptoms

Pulmonary embolism may have no symptoms; it can cause sudden, unexpected death. When symptoms do occur, they may include:

• Sudden or severe chest pain, especially during inspiration
• Shortness of breath or difficulty breathing
• Coughing up blood
• Dizziness, lightheadedness, or fainting
• Excessive sweating
• Bluish tinted skin (hypoxia)
• Anxiety

Diagnosis

Pulmonary embolism can be difficult to diagnose because its broad symptoms may resemble other diseases. A history and physical examination are very important, and may be used in conjunction with a chest x-ray, electrocardiogram (ECG), arterial blood gases, D-dimer assay, ultrasound of the legs, spiral computed tomography (CT), lung scan, and pulmonary arteriogram.

Treatment

Most cases of pulmonary embolism are treated with a series of blood-thinning agents, anticoagulant medicines, and clot-dissolving medicines (thrombolytic therapy). Oxygen and sedatives may be given for patient comfort. In rare cases, thoracic surgery is needed to remove a clot.


Resources

Texas Heart Institute www.texasheartinstitute.com/HIC/Topics/Cond/pvd.cfm
American Medical Association http://jama.ama-assn.org/cgi/reprint/295/2/240.pdf
Medline Plus www.nlm.nih.gov/medlineplus/pulmonaryembolism.html
American Heart Association www.americanheart.org/presenter.jhtml?identifier=3057360