Pulmonary Embolism in the United States - Essay Example

Pulmonary Embolism Pathology 19th Jul 2006 Pulmonary Embolism Each year in the United s more than 600,000 people have apulmonary embolism. More than 60,000 of them succumb to the complication. Many of those who die do so within 30 to 60 minutes after symptoms start. It is one of the most common causes of death in hospitalized people who must remain in bed for a long time. A pulmonary embolism is characterized by an abrupt blockage in a lung artery, commonly due to a blood clot that has traveled to the lung from the leg. More than 90 percent of the blood clots that cause pulmonary embolism usually form in the deep veins of the legs, a condition called deep vein thrombosis or DVT. The clots can break free, travel to the lung, and block an artery. The condition can uncommonly be caused from fat escaping from fractured bone marrow or from amniotic fluid during childbirth. With a large clot, or many number of clots, pulmonary embolism can cause death. Pulmonary embolism is a serious condition that can cause: Permanent damage to part of the lung from lack of blood flow to lung tissue Low oxygen levels in the blood Damage to other organs in the body from not getting enough oxygen The process by which a pulmonary embolism forms, begins in the blood stream. Blood flows from the right side of the heart to the lungs where it picks up oxygen. The heart pumps this oxygen-rich blood through arteries delivering it to various parts of the body after which it enters another network of veins. The veins carry the now oxygen-poor blood back to the heart, which pumps the blood to the lungs to pick up oxygen again. A blood clot forming in a vein, commonly a deep vein in the leg, can travel with the blood flow back to the lungs and become lodge there.This leads to pulmonary embolism. When the lung arteries become blocked by a blood clot, high blood pressure in the lungs may occur. This results in the heart having to pump harder than usual. A continually overworked heart may enlarge and may eventually fail to function. A large pulmonary embolism can result in failure of both the lungs and heart. However, the sooner a physician can diagnose and treat the condition, increases the chances of surviving a pulmonary embolism. The symptoms of pulmonary embolism differ widely and often resemble those of other conditions; the classic signs include sudden shortness of breath, chest pain and a cough that produces blood-streaked sputum. Breathing may be very rapid and breathing deeply may cause severe chest pains. Other symptoms include increased pulse rate, dizziness, and fainting. Pulmonary infarction may result if there is a lack of blood flow to the lungs causing some lung tissue to die. In addition the patient may also cough up blood-stained phlegm, have sharp chest pains, and fever. The skin may turn a bluish color from a lack of oxygen when the larger vessels of the lungs are blocked. Chronic pulmonary embolism, where small blood clots deposit themselves in the lungs repeatedly over time, will cause shortness of breath, swelling of the leg and all round weakness (MayoClinic 2006). Risk factors for a pulmonary embolus include: Prolonged bed rest or inactivity (including long trips in planes, cars, or trains), Oral contraceptive use, Surgery (especially pelvic surgery), Childbirth, Massive trauma, Burns, Cancer, Stroke, Heart attack, Heart surgery, Fractures of the hips or femur A blood clot is the first factor towards pulmonary embolism and one that forms in a vein is called a thrombus. A blood clot is a plug of platelets enmeshed in a group of red blood cells and fibrin. Blood clots usually develop to help stop bleeding an injury, but sometimes form without reason. A clot that develops in one part of the body and travels in the bloodstream to another part of the body is called an embolus. Sometimes other substances, such as pieces of a tumor, globules of fat from fractured bones or air bubbles, may enter the bloodstream and become an embolus that blocks arteries. A vein in the leg or pelvis is the point where most clots that cause problems originate. The vein may be near the skin surface (superficial thrombosis) or deep within a muscle (deep vein thrombosis). Clots in superficial veins normally clear on their own but clots in deep veins may separate and travel through the bloodstream to the lungs. Most of the clots in the legs begin in the veins below the knee, and it's rare for these clots to separate. Occasionally clots may reach up into the thigh tending to increase the danger. The reason why clots detach is unclear and predicting when that will happen is difficult. There are various factors involved in clot formation. Heredity plays a role in about half the people who develop abnormal blood clots. Another leading cause of formation of blood clots is surgery, especially operations to replace major joints, such as the hip and knee. Long periods of inactivity from prolonged bed rest or long plane or car trips decreases blood flow into the veins and increase the likelihood of clots developing. A rise in clotting substance in the blood including types of cancer, particularly pancreatic, lung and ovarian cancers, cause increased blood levels of procoagulants. Estrogen found in birth control pills and hormone therapy also increases the amount of clotting factors in the blood. Some medical conditions, cardiovascular disease associated with clot formation, such as heart attack or stroke, are more likely to develop blood clots in their veins. As an initial treatment a vascular surgeon or physician might treat a pulmonary embolism by administering an anticoagulant drug called heparin intravenously. Although anticoagulants are called blood thinners they don't thin blood, instead prevent blood from clotting too easily. Heparin helps prevent blood clots from developing and prevents any clots already in the system from growing. After a period of time the body breaks up the clot that caused the pulmonary embolism. A large pulmonary embolism may be treated with more aggressive treatments such as thrombolysis which can dissolve clots. This procedure involves using a catheter to inject clot-dissolving drugs directly into the clot. If the pulmonary embolism is large, thrombolysis may be effective with dealing with it but can cause complications such as bleeding and stroke and is a high risk procedure than anticoagulant therapy (Vascular Web 2006). Seeking medical advice quickly is the best measure to prevent complications from arising. DVT can occur without any signs or symptoms. If a clot exists in a vein in the leg, it can frequently cause redness, swelling or tenderness on that region of the leg. To confirm that the problem is caused by a blood clot and not some other condition, a doctor may perform some tests. If the clot reaches the lungs, it may lead to a life threatening situation. Prompt medical advice and treatment should be immediately sought. About one in 10 people with pulmonary embolism die within the first hour. When diagnosed and treated quickly pulmonary embolism is rarely fatal. References FDA (2004). Avoid Deep Vein Thrombosis: Keep the Blood Flowing. U.S. Food and Drug Administration. Retrieved 18th Jul 06 from http://www.fda.gov/fdac/features/2004/604_vein.html MayoClinic (2006). Diseases and Conditions. Pulmonary Embolism. Retrieved 19th Jul 06 from http://www.mayoclinic.com/health/pulmonary-embolism/DS00429/DSECTION=5 Vascular Web (2006). Pulmonary Embolism. 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