Home :: Pulmonary Embolism

Pulmonary Embolism - Symptoms and Treatment

Causes

Clots are most likely to form in association with any of the following:

• Injury to the pelvis, thigh or leg, especially dislocations, contusions and fractures.
• Use of oral contraceptives, especially in women over age 35.
• Any injury, illness or surgery that requires prolonged bed rest. This can lead to pooling of blood in veins.
• Sitting in one position for a prolonged period.
• Heart-rhythm disturbance.
• Hemolytic anemia.
• Polycythemia (see Glossary).
• Smoking.
• Pregnancy.

Signs and symptoms

• Sudden shortness of breath.
• Faintness or fainting.
• Pain in the chest.
• Cough (sometimes with bloody sputum).
• Rapid heartbeat.
• Low fever.

These symptoms are often preceded by swelling and pain in the leg or thigh.

Diagnosis

• Laboratory blood studies to regulate anticoagulant medication dose.
• X-rays of the chest.
• Chest CT scan and radioactive studies to establish presence and extent of a clot in the lung.
• Echocardiogram
• An ECG may show abnormalities caused by strain on the heart.

Treatment

Medical Treatment

• Hospitaization for anticoagulation, oxygen and possible surgery.

Thrombolytic therapy (clot-dissolving medication) includes streptokinase, urokinase, or t-PA. Anticoagulation therapy (clot-preventing medication) consists of heparin by intravenous infusion initially, then oral warfarin (Coumadin). Subcutaneous low-molecular weight heparin is often substituted for intravenous heparin in many circumstances.

Home Treatment

• Wear elastic stockings or leg wraps willi elastic bandages.
• Don't sit with your legs or ankles crossed.
• Elevate your feet higher than your hips when sitting for long periods.
• Elevate the foot of your bed.

Prevention

• Observe safety regulations and wear protective equipment for contact sports to prevent injury whenever possible.
• Don't smoke, especially if you are a woman 35 or older who takes birth-control pills.
• Avoid prolonged bed rest during illnesses. Wear elastic support stockings during recuperation from surgery or illness. Start moving lower limbs and walking as soon as possible.
• When traveling, stand and walk every 2 hours.