Pulmonary Embolism

A pulmonary embolism can also be known as Venous Thromboembolism. The disease generally will affect those who are inactive for long periods including plane and car trips or have prescribed bed rest. Other risk factors of a pulmonary embolism include oral contraceptive use, pelvic surgeries/surgery in general, childbirth, massive trauma, burns, cancer, stroke³. The abnormal condition is best described as a thrombus that forms in a vein, (generally within the leg/pelvic area known as a deep vein thrombus) then becomes an embolus which travels through your natural flow of blood, and ends up getting lodged in your pulmonary artery¹. Once the embolus is stuck in a large artery of the lung the amount of blood supply becomes insufficient, this causes death of lung tissue.¹ Just about 10% of people with an embolism will suffer lung tissue death². At times the body will be able to break up small clots quickly. Larger clots take longer to disintegrate so larger embolus’s will do more damage and also can cause sudden death if the lung arteries oxygen supply is inadequate to sustain any life¹.

The normal condition without pulmonary embolism would be that there is no embolus lodged or created. Without an embolism the lungs would function normal by carrying enough blood containing oxygen and nutrients to keep the tissue healthy and also to carry carbon dioxide out of the body¹. The bloodstream and blood flow in a normal condition would then be expected to be free of any floating cloats. For a normal condition to be sustained thus free of any embolus’s the patient must be active and in adequate health. As well as not having any other risk factors mentioned.

To compare between a normal condition and a diseased, could easily start with the health of the patient. Most patients experiencing embolisms are inactive, or have inadequate health/risk factors therefore a patient with a normal condition will be in good active health and free of any risk factors. The diseased if not treated will expience death of lung tissue, that in certain circumstances can be fatal. A patient with a normal condition will be able to receive adequate support of blood and nutrients free of emboli and will be able to continue as normal.

There are a few different treatment methods of a pulmary embolism, all depending on factors relating with each patient. Generally all patients will receive oxgyen and if pain medication is needed it is provided¹. The medications for patients that are at risk of ongoing embolisms or new clots are anticoagulant drugs which are known as Heparin and Warfarin¹. These two medications will be used together for around 5-7 days¹. Heparin is given intravenously for the rapid-effect. Warfarin is used for the long-term effect and is given by mouth, blood tests then will be used to confirm when heparin can be discontinued¹. Another treatment called Thrombolytic therapy, is used on patients who are at risk of dying. Drugs that are used for this treatment include streptokinase and TPA (tissue plasminogen activator) both are used to dissolve the clot³. Surgery is also a treatment method for severe cases. A filter known as an umbrella is placed in the main vein to prevent clots from reaching the lung, generally clots that become trapped are able to dissolve on their own¹.

Management issues will depend on each patient, and will then determine the time treatment needs to be continued until safe of any reoccurrences². For an example a patient who has a temporary embolism due to known risk factors, the anticoagulant drugs are used for 2-3 months after². Frequent blood tests will also be expected to make sure doses are correct and stable². 50 percent of people who have experienced an embolism and were untreated will then be likely to have another¹. Generally 2 in 5 patients of reoccurrences will again become severe². Patients are then advised to watch for symptoms that include, shortness of breath and chest pains signaling chance of a reoccurrence³. Once treatments are prescribed, patients would be expected to continue on as normal to eventually reach and recover to the normal condition summarized before.

¹ : Beers, M. 2003, pp. 285-289

² : Leikin, J & Lipsky, M. 2003 pp. 374-375

³ : Internet Reference,