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Pulmonary Embolism


What is a pulmonary embolism?

A pulmonary embolism (PE) is the sudden blockage of a blood vessel in the lungs by an embolus. An embolus is usually caused by a blood clot, but may also be fat, air, or tumor cells. The blood clot may break loose from the blood vessels in your leg or arm. The clot travels to the lungs where it cuts off the blood supply to your lungs.

What increases my risk for a PE?

  • Obesity
  • Smoking
  • Birth control pills
  • Certain blood diseases, such as thrombophilia and hyperhomocysteinemia
  • Medical conditions, such as a deep venous thrombosis (DVT) or cancer
  • Pregnancy and childbirth
  • Recent surgery
  • Sitting or lying in one position for a long time, such as when you travel by plane

What are the signs and symptoms of a PE?

  • Fast heartbeat
  • Sudden shortness of breath or fast breathing
  • Sudden chest pain that is worse when you take a deep breath
  • Bluish nails
  • Cold, pale, clammy skin
  • Fever and coughing up blood
  • Fainting

How is a PE diagnosed?

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to look for signs of a lung infection or other damage.
  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your lungs. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.
  • Lung scan: This test is also called a V/Q scan. A small amount of radioactive dye is used to study your airflow (ventilation) and blood flow (perfusion [Q]). First, you breathe in medical gas. Pictures are taken to see how well your lungs take in oxygen. Then, dye is injected into a vein. Pictures are taken to see how blood flows in your lungs.
  • Pulmonary angiogram: This test is used to check for problems with blood flow in your heart and lungs. A catheter (long, thin, bendable tube) is placed in a vein in your neck, under your collarbone, or in your groin. The catheter is then threaded into the pulmonary artery. Dye is put into the catheter and x-rays are taken. The dye helps caregivers see your blood vessels better on the monitor. Tell the caregiver if you have ever had an allergic reaction to contrast dye.
  • Doppler ultrasound: This test uses sound waves to show pictures of your lungs on a monitor. An ultrasound may show the PE.

How is a PE treated?

  • Medicines:
    • Clot busters: This medicine helps break apart clots. It is given through your IV and may be given at the same time as other blood thinners.
    • Blood thinners: This medicine helps stop clots from forming in your blood. You may bleed or bruise more easily.
  • Surgery: You may need surgery if you cannot take blood thinners or have recurrent blood clots. A filter may be inserted into your blood vessel to catch blood clots traveling to your lungs and heart. You may also need to have the blood clot removed.

What are the risks of a PE?

You have a higher risk for another PE. The blood clot may block the blood flow to your heart and lungs. This can be life-threatening. You may bleed more than expected if you take blood thinners. Without treatment, the PE can cause your lungs and other body organs to stop working. This can be life-threatening.

How can I decrease my risk for another PE?

  • Wear pressure stockings: These tight stockings put pressure on your legs to increase your blood flow. Wear the stockings during the day. Do not wear them when you sleep.

  • Maintain a healthy weight: Ask your caregiver how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.
  • Be active: When you travel by car or plane, take breaks to stand up and move around as much as possible. Rotate your feet in circles often if you sit for a long period of time. Ask your caregiver about the best exercise plan for you. This will help increase your blood flow.
  • Do not smoke: If you smoke, it is never too late to quit. Ask for information about how to stop smoking if you need help.

When should I contact my caregiver?

Contact your caregiver if:

  • The skin on any part of your legs or hips turns purple.
  • Your gums or nose bleed.
  • You see blood in your urine or bowel movements.
  • Your bowel movements are black or darker than normal.
  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You feel faint.
  • Your heart is beating faster than normal.
  • You have a seizure or severe headache.
  • You have slurred speech, increased sleepiness, or problems seeing, talking, or thinking.
  • You have weakness or cannot move your arm or leg on one side of your body.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You suddenly feel lightheaded and short of breath.
  • You have chest pain when you take a deep breath or cough. You may cough up blood.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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