PULMONARY EMBOLISM |
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General Information
DEFINITION--A blood clot or fat cells that block one of the arteries carrying blood to the lungs. The blood clot usually begins in an inflamed deep vein of the leg or pelvis (phlebitis). A fat embolus usually begins at a fracture site. This blockage decreases breathing ability and sometimes destroys lung tissue.
SIGNS & 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.
CAUSES & RISK FACTORSClots 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.
HOW TO PREVENT
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.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Medical history and exam by a doctor.
Laboratory blood studies to regulate anticoagulant medication dose.
X-rays of the chest.
CAT scan (See Glossary) and radioactive studies to establish presence and extent of a clot in the lung.
SURGERY(Rare) To tie off the big vein leading to the heart and lungs (vena cava) or for insertion of a filter to trap recurrent clots.
NORMAL COURSE OF ILLNESSUsually curable in 10 to 14 days with treatment.
POSSIBLE COMPLICATIONS
Rapid death from a large clot that obstructs more than 50% of the blood to the lungs.
Massive bleeding in the lungs caused by smaller clots.
Congestive heart failure and chronic lung disease after repeated episodes of embolism.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTHospitalization for anticoagulation, oxygen and possible surgery.
HOME TREATMENT
Wear elastic stockings or leg wraps with 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.
MEDICATIONYour doctor probably will prescribe anticoagulant drugs to dissolve and prevent clots. The anticoagulant level must be monitored to keep it in a safe range.
ACTIVITY
Rest in bed until all symptoms and signs of clots and embolism disappear. While in bed, move your legs often to stimulate circulation.
Resume light exercise only after clearance from your doctor--usually within 2 weeks. Don't participate in active exercise or training until the deep vein clot has disappeared and anticoagulants can be safely discontinued.
It will probably be 3 or 4 additional weeks before your doctor clears you for exercise or reconditioning. Having a pulmonary embolus DOES NOT prevent you from participating in athletics in the future.
DIETNo special diet.
CALL YOUR DOCTOR IF
You have symptoms of pulmonary embolism or phlebitis (vein inflammation). This is an emergency!
The following occurs during treatment:
Chest pain, coughing up blood or shortness of breath.
Increased swelling and pain in the leg.
You take anticoagulants and develop any signs of internal bleeding, such as vomiting blood, blood in stool or severe abdominal or back pain.
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