About this disease
What it is about
In a pulmonary embolism, an arterial pulmonary vessel becomes narrowed or completely blocked. The blood clots (thromboses) that lead to the occlusions originate in 90% of cases from the leg veins, detach from the vessel wall there and are washed into the pulmonary arteries with the blood flow (embolus). There are also rarer forms of pulmonary embolism caused by amniotic fluid, fat, tissue fragments, or air passing from the veins into the pulmonary arteries.
Types
The risk factors for pulmonary embolism are identical to those for thrombosis. These include immobilization during illness or after surgery, coagulation disorders, cancer, certain medications, the pill, pregnancy, and smoking.
Symptoms and consequences
Pulmonary emboli can present differently depending on the size of the section of the pulmonary circulation that is affected and how close the affected lung section is to the pleura. Typical symptoms include shortness of breath, chest pain when breathing, coughing, rapid pulse, coughing up blood, restlessness, anxiety, loss of consciousness, circulatory problems, and shock.
What we do for you
Examination and diagnosis
The diagnosis is not easy to make because the symptoms coincide with many other health problems. The most important thing is to obtain a precise medical history and risk factors, and to perform a physical examination. This involves listening to the lungs and measuring blood pressure/pulse and oxygen saturation. In some cases, a value in the blood (D-dimer) can help. The most important examination is computed tomography of the lungs. Scintigraphy can show pulmonary emboli, but is rarely available. Extended diagnostics include an ECG.
Treatment
Small pulmonary embolisms require several months of blood-thinning therapy in tablet form. In larger thromboses, where oxygen exchange is impaired, additional hospitalization for monitoring and oxygen administration may be necessary. Rarely, the initial presentation is so massive that treatment in the intensive care unit is necessary. In such life-threatening cases, a special form of blood thinning therapy called lysis therapy is available.