Pulmonary Embolism (PE)
What is Pulmonary Embolism (PE)?
Pulmonary embolism (PE) occurs when a blood clot (thrombus) dislodges from a vein, travels through the bloodstream, and lodges in the lung.
If a clot blocks the blood flow to parts of the lung, it prevents oxygen from reaching the brain and body. Pulmonary emboli are uncommon, but can be deadly if not identified and treated promptly.
What are the risk factors?
- Recent surgery (especially hip, pelvis, or knee surgery).
- Immobility (e.g., due to hospitalization, recovery from injury, bedrest, or paralysis).
- Smoking
- Some medical conditions and medications increase your risk of developing a blood clot:
- • Cancer
- • Heart failure
- • Kidney problems, such as nephrotic syndrome
- • Previous DVT or PE
- • Age ≥65 years
- • Obesity
- • Pregnancy
- • Inherited thrombophilia (genetic problem that causes the blood to form clots more easily than normal).
- • Certain medications (eg, birth control pills, hormone replacement therapy, tamoxifen, thalidomide, erythropoietin, cancer chemotherapy medications).
What are the symptoms?
- Shortness of breath or needing to breathe rapidly.
- Chest pain, especially sharp, knife-like pain while taking a deep breath.
- Coughing or coughing up blood.
- A rapid heart rate.
- Dizziness or fainting.
What are the diagnostic tests?
- D-dimer
- Computed tomography pulmonary angiography (CTPA).
- Ventilation/perfusion lung scan (V/Q scan).
What is the treatment?
Anticoagulation — Anticoagulants are medications that are commonly called “blood thinners.” They do not actually dissolve the clot but rather help to prevent new blood clots from forming. For Example:
- a. Direct oral anticoagulants (DOACs)
- b. Warfarin
- c. Low-molecular-weight (LMW) heparin, which is given as an injection under the skin.
- d. Fondaparinux, also given by injection.
- e. Unfractionated heparin, which is given into a vein (intravenously) or as an injection under the skin.
Duration of treatment — Anticoagulation is recommended for a minimum of three months in a patient with PE.
How to prevent PE?
- Walking as soon as possible after surgery.
- Adequate hydration.
- Taking blood thinners on time when prescribed.
- Proper follow up appointments with physician.
How to reduce risk of bleeding?
- Use a soft bristle toothbrush.
- Use a humidifier to help reduce nosebleeds (if you live in a cold or dry climate).
- Use caution when handling sharp objects (eg, knives).
- Avoid activities that could result in injury (eg, contact sports).
- Use appropriate safety equipment (eg, helmets, padding) during physical activity.
- Avoid aspirin or other nonsteroidal anti-inflammatory agents (NSAIDS); unless your health care provider tells you to take them.
- Wear an alert tag.
