- What is Pulmonary Embolism?
Pulmonary embolism occurs as a result of blockage of one or more branches of the pulmonary artery. It is a serious disease. The cause of blockage is usually a clot that forms in veins in other parts of the body and reaches the lung vein through the bloodstream. Rarely, it may occur due to other reasons such as fat embolism, air embolism.
- In whom is lung embolism most common?
Pulmonary embolism can occur in anyone. However, the risk increases in the presence of predisposing factors, and especially in the presence of more than one factor.
- What are the predisposing factors?
- Current health status:
- Heart diseases: the risk of clot formation increases in high blood pressure and cardiovascular diseases
- Cancer: Especially pancreas, ovaries Clot formation becomes easier in lung cancer and all cancers that have spread throughout the body. Use of tamoxifen or raloxifene in breast cancer increases the risk.
- Long-term inactivity:
- Long-term bed rest due to surgery, trauma, chronic disease
- A journey lasting more than five hours in a sitting position
- Surgery:
- Especially hip and knee prosthesis surgeries are a risk factor for embolism. To reduce this risk, blood thinners are generally administered for protective purposes before and after the surgery.
- The risk increases as the duration of general anesthesia applied during the surgery increases.
- Simply, in all types of surgery, it is necessary to remain immobile and lie down. The risk increases as the duration of addiction increases. For this reason, physicians try to get their patients up and walking as soon as possible after surgery.
- Other factors: In the presence of more than one risk factor, the following situations increase the risk of clot formation and embolism.
- Smoking
- Obesity: Obesity facilitates clot formation, especially in smokers and those with high blood pressure.
- Estrogen (female hormone) use: Birth control pills, menopause or hormone therapy for other reasons Heat paves the way for clot formation. Hormone use in women who smoke further increases the risk.
- Pregnancy slows down blood circulation in the leg and hip veins, paving the way for clot formation.
- Genetic predisposition
- How does pulmonary embolism occur?
Preparator In the presence of these factors, embolism occurs when the clot, which often forms in the leg veins, breaks away from its location, enters the bloodstream, and reaches the heart and then the pulmonary arteries. Depending on the size of the clot, blockage occurs in larger or smaller vessels.
- What are the symptoms of pulmonary embolism?
Depending on the size of the clot and the severity of the underlying disease, symptoms vary from mild shortness of breath and chest pain to severe respiratory and circulatory failure and sudden cardiac and respiratory arrest.
Often. the following symptoms occur:
– Shortness of breath: Typically begins suddenly and worsens with exertion; The patient's breathing has accelerated and the number of respirations per minute has increased (the patient is almost out of breath). There may also be a pain in the form of a stinging side ache that increases with deep breathing
– Cough, bloody sputum or blood in the form of streaks in the sputum
– Leg pain, swelling, redness: Diameter between the two legs. It manifests itself with temperature and color changes, suggesting that a clot has formed in the leg veins. Rarely, it may occur in both legs.
– Symptoms such as bruising on the fingertips and lips, fever, sweating, palpitations, and dizziness occur less frequently.
6- What When should you go to the doctor?
Pulmonary embolism is a serious and life-threatening disease. In case of sudden and unexplained shortness of breath, rapid breathing, chest pain and bloody sputum, a physician should be consulted immediately.
7- What is the course of the disease?
Pulmonary embolism. It is a life-threatening disease and It is a cause of "sudden death". Unfortunately, it results in death before diagnosis in approximately one-third of patients. However, if diagnosis and treatment are started immediately and as the treatment progresses, this risk decreases day by day.
Pulmonary embolism is a disease that can recur; The risk of developing an embolism is higher in those who have had an embolism once than in those who have never had this disease. Recurrent embolism may lead to the development of hypertension in the lung vessels over time.
8- How is the diagnosis of pulmonary embolism made?
The history of the disease and clinical findings are very important in diagnosis. For this reason, patients should clearly state their complaints and tell their physicians about their previous health status. It should express situations that require long-term travel or long-term bed rest.
In a patient with suspected pulmonary embolism, a series of examinations such as blood tests, lung x-ray, heart graph, leg ultrasound, tomography, scintigraphy and angiography are performed. While sometimes one or two of these tests may be sufficient for a definitive diagnosis, sometimes all tests, including angiography, may be required.
9- How is the treatment performed?
To the patient with suspected pulmonary embolism. It is essential to start treatment as soon as possible. In other words, the diagnosis does not need to be confirmed to start treatment.
- Medical Treatment: Drug treatment is sufficient for the majority of patients. Treatment is with anticoagulant (blood thinner) or clot-dissolving medications. Since clot-dissolving drugs can cause serious bleeding, they are used only in emergency and life-threatening situations. Afterwards, anticoagulants are continued. This treatment continues for at least 6 months.
- Other procedures: If there is a very large clot in the pulmonary vein, the clot can be removed directly by surgery. In cases of recurrent embolism and in patients who cannot use blood thinners, a strainer can be placed in the vena cava, the main vein of the body. These procedures are required very rarely.
10- Things that patients using anticoagulants should pay attention to:
Patients after discharge due to the long duration of the treatment. On an outpatient basis, the effectiveness of the blood thinner is tested with blood tests and the drug dose is adjusted. Blood clots with these types of drugs As the bleeding time increases, bleeding tendency increases. If you have long-lasting nosebleeds, blood in your saliva, urine or stool, black stools, or bruises that appear on your body without any impact, you should consult your doctor, even if you do not have a check-up date.
Traffic accident, assault, injury, fall. Even if there is no visible wound or bruise in cases such as severe headache, you should definitely consult your doctor because there may be internal bleeding. It will guide physicians during emergency intervention in accidents involving loss of life.
Anti-clotting drugs interact with other drugs. Therefore, you should inform your doctor if you need to use another medication. Preferring medications containing "paracetamol" as a pain reliever; It is recommended that you do not use aspirin and antirheumatic drugs.
Anti-clotting drugs are also affected by nutrition. While excessive consumption of foods rich in vitamin K (green leafy vegetables such as broccoli, lettuce, spinach, peas, liver, egg yolk, wheat bran, cheddar cheese, soybean oil) reduces the effect of the drug and facilitates clot formation; Foods such as red pepper, chamomile, garlic, ginger, green tea and turmeric also increase the effect of the drug and increase the tendency for bleeding. Therefore, it is necessary to be careful about nutrition.
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