Are you a frequent air traveler? Does your job involve sitting for extended periods of time? Are you obese and have a family history of heart disease? If you answer yes to any of these questions, then you may be at risk for pulmonary embolism.
What is pulmonary embolism?
The term pulmonary embolism (pulmonary artery embolism) refers to the sudden obstruction of the pulmonary artery with a blood clot or emboli. This condition can be life-threatening due to the blockage of blood flow into the lungs.
How does a pulmonary embolism happen?
In normal conditions, blood is usually contained within blood vessels and its flow is not impeded by blood clots. However, when there is stasis within the blood, such as when you sit for long periods of time, blood clots can form. These clots are called thrombi and they usually vary in sizes. Sometimes, these thrombi break free from their origins to lodge in a different part of the body. These displaced blood clots are called emboli.
Pulmonary embolism occurs when emboli from the blood vessels in the legs deposit itself in the pulmonary artery.
Types of Pulmonary Embolism
Most of the time, pulmonary embolism is caused by blood clots. However, there are instances when the obstructing object is not a blood clot. These types of emboli include.
The term “air embolism” is used when an air bubble blocks a blood vessel and obstructs its blood flow. This can occur as a complication of certain medical procedures.
This occurs when droplets of fat obstruct the flow of blood. This is a common complication of fractures involving long bones. In these fractures, the fatty bone marrow enters the blood vessels and obstructs it.
Septic embolism occurs when a parasitic mass of dead cells or tissues obstructs the flow of blood. This foreign body behaves like a clot and causes the same effects.
Pulmonary embolism is a major complication of phlebitis, the term used to describe the inflammation of the veins. It is a major concern for patients who were recently operated upon, patients who are bedridden, and women who have given birth with obstetric complications.
Long air travel also promotes venous thrombosis and pulmonary embolism, even if you are apparently healthy. The contributing factors include:
- The reduced atmospheric oxygen at high altitudes.
- Dehydration: Due to the low humidity of the surrounding air as well as the aggravating effect of alcohol.
- Prolonged sitting which causes stasis and pooling of the venous blood in the lower limbs.
Symptoms of Pulmonary Embolism
Acute pulmonary embolism is fatal and appears suddenly. The onset is marked by:
- Chest pain
- Rapid breathing
- Excessive sweating.
- Cyanosis: This is the bluish discoloration of the skin which is common in conditions where blood flow to the lungs is affected.
Other signs and symptoms of PE include:
- Vague chest pain
- Respiratory discomfort
- Blood within the saliva
- Swelling or pain in the leg
- Dizziness or lightheadedness
- Irregular or rapid heartbeat
Treatment of Pulmonary Embolism
Anticoagulants (blood thinners)
This dissolves the clot and allows smooth blood flow within the obstructed vessel. Heparin is a common anticoagulant used in urgent PE treatment. In cases of shock, the use of Fraxiparin along with the use of oxygen and sedatives is advocated.
In the absence of any improvement, other urgent PE treatment can be carried out. These includes:
This is the use of drugs like streptokinase or Urokinase to break down the blood clots.
Here, the blood clot causing the lung obstruction is surgically removed. The subsequent treatment is based on long-term oral anticoagulation therapy.
To prevent recurrence of this condition, the risk factors should be reduced, and the use of long-term anticoagulant therapy should be considered.
The prevention of PE is important especially in patients who are susceptible to deep venous thrombosis.
Bedridden or convalescing patients are most prone to DVT. In these patients, the use of anticoagulants like Antivitamin K, standard heparin or low-molecular-weight heparins like Fragmin or Fraxiparin, is effective in the early treatment of phlebitis involving the lower limbs.
Useful tips for traveling by plane.
- Avoid smoking for a few days before the flight.
- Avoid drinking alcohol during the flight.
- Drink lots of non-alcoholic fluids.
- Elevate your legs.
- Use support stockings.
- Take a short walk down the aisles during air travel (choose seats near the aisles).
- You should also eat foods that stimulate blood circulation.
- Use preventive anticoagulant therapy in susceptible patients.