Pulmonary embolism

Pulmonary embolism is a blockage in the blood vessels of the
lungs. In most cases, the blockage occurs when a blood clot travels
from a point downstream in the circulation and gets stuck, as the
vessels become narrower in the lungs.

DESCRIPTION

Pulmonary emboli are a problem for many patients following an
operation. The most common site for a clot to form is in the deep
veins of the leg (deep vein thrombosis), which detaches and is
transported by the blood to a smaller vessel which it then
blocks.

 

When the clot plugs an artery in the lungs, the blood supply
to the segment of lung beyond that point can collapse and die,
forming an area of scar tissue. The degree of damage depends on the
size of the artery blocked and whether or not an alternative way
for blood to reach that area of lung exists. Some clots are so tiny
and have so little effect on the lung that the person never knows
that they have occurred. Larger or more extensive emboli are
medical emergencies because they can rapidly lead to death. Small
clots can enlarge once they plug an artery and gradually destroy
larger and larger areas of lung.

 

When treatment is given quickly enough, most patients who
survive the first hour following a Pulmonary Embolus will go on to
live a normal life. Large areas of damaged lung may lead to a
condition called cor pulmonale, a progressive failure of the right
side of the heart.

 

• Immobility from bed-rest, surgery, limb paralysis, etc.
• Injury to the vein through trauma or medical procedures
• Factors which increase the tendency of the blood to clot
  including malignant diseases, some drugs (contraceptive pill),
  dehydration, some kidney disorders and ulcerative colitis
• Ageing.

SYMPTOMS

• Sometimes there are no symptom
• Sudden chest pain 
• Sudden shortness of breath
• Coughing of blood or pink-stained frothy mucus
• Collapse
• Fever 
• Increased heart rate.

TREATMENT OPTIONS

Note: If you suffer from chest pain and shortness of breath,
seek medical advice immediately. In no way is this information
intended to replace the advice of a medical practitioner.

• Treatment must be sought as soon as possible. This prevents
  enlargement of the clot. Anticoagulants (medications that thin the
  blood) are often used immediately and then over the months
  following the pulmonary embolus. Drugs that can help dissolve the
  clot (thrombolytics) may be used in some cases. In rare cases where
  repeated clots are a problem, a small filter may be inserted to
  prevent the clots from travelling to the lungs. 
• Some experts recommend that anyone with a higher risk of clots
  should have one low-dose aspirin tablet a day, to help keep the
  blood thin. Talk to your pharmacist to discuss the risks and
  benefits. Note: aspirin should not be given to children under 16
  years of age unless specified by a doctor. Aspirin should be
  avoided in children aged 12 -15 if they are feverish.

PREVENTION

Preventing blood clots in the legs is an important step in
preventing pulmonary emboli. This can include:

• Compression stockings
• Early mobilisation after surgery
• Exercise 
• Physiotherapy 
• Drink plenty of fluids to keep well-hydrated and be aware that
  alcohol, tea and coffee can increase fluid loss from the body.
• Quit smoking
• Lose weight if necessary.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice

1. Your Pharmacy stocks a range of compression stockings which may
   help to reduce the risk of developing thrombosis by helping to
   improve the flow of blood in the leg veins.
2. Stop smoking. Smoking is a major risk factor for the
   development of thrombosis. A variety of products have been designed
   to make quitting easier and your Pharmacist can offer guidance and
   support.
3. Ask your Pharmacist for advice about healthy weight
   management.