An Introduction To Pulmonary Embolism And Associated Complications

When blood arrives in the heart, it lacks oxygen. It is pumped via the pulmonary arteries to the lungs, where carbon dioxide is removed and exchanged with oxygen. The blood then returns to the heart, and is pumped to the body to provide oxygen to the organs. If material clogs one of the arteries of the lungs, the blood moving through the vessel will be unable to reach the lung tissue. This is known as a pulmonary embolism. It causes numerous problems, and is occasionally fatal.

We’ll describe the condition in detail below, and explain why it can be so dangerous. We’ll also take a close look at how it is diagnosed. Finally, you’ll learn about the methods doctors take to restore blood flow through the blocked artery.

What Is A Pulmonary Embolism?

Technically, a pulmonary embolism (PE) is defined as any blockage in the arteries of the lungs, regardless of how it happens. In most cases, the condition results from a blood clot (thrombus) in the legs. It breaks off, and travels to the heart, after which it is pumped into the pulmonary arteries with the blood.

The body can break down small clots on its own, often before they cause a blockage. Unfortunately, if a thrombus is large, this process occurs too slowly. The clot will travel through the vessel, and eventually get stuck when the passage becomes too narrow to continue. At that point, a partial or complete obstruction occurs.

Reasons A PE Is Considered Dangerous

As much as the body depends on the lungs to oxygenate the blood, the lungs also depend on a constant supply of blood from the right side of the heart. By blocking an artery, a blood clot – or any material that causes an obstruction – starves the portion of lung tissue that normally receives blood through it. If the problem is quickly corrected, and blood flow is restored, tissue damage will be minimal. On the other hand, a blockage that persists will eventually cause permanent tissue damage.

A pulmonary embolism can also cause high blood pressure in the pulmonary arteries and the right ventricle (bottom chamber of the heart). This occurs as the chamber continues to pump blood into the blocked vessel. The rising pressure is known as pulmonary hypertension, a condition that introduces additional problems. The right ventricle has to work harder in order to pump blood to the lungs. It can do so for awhile, but will eventually tire out. With time, the stress placed upon it will cause the chamber to fail.

Diagnosing Blockages In The Arteries Of The Lungs

Confirming that a pulmonary artery is obstructed is more difficult than it seems. One of the reasons is that clots in the lungs rarely appear on x-rays. Moreover, symptoms of a PE (breathing difficulties, chest pain, etc.) could be caused by several unrelated conditions.

An ultrasound is usually done on the patient’s legs since most of the thrombi that end up in the arteries of the lungs begin there. A CT (computed tomography) scan is also done. A contrast dye injected into the patient’s arm, and allowed to circulate to the heart and pulmonary arteries. Images are taken of the dye, which helps display clots.

A lung scan is also helpful. It is conducted in two phases, one to test the patient’s air passages, and the other to test blood flow through the arteries of his or her lungs.

With the results of several tests, the doctor can usually confirm a PE. The priority then switches to restoring blood flow through the blocked artery.

Restoring The Flow Of Blood To The Lungs

If the blockage is small, anticoagulation drugs are usually given to the patient. These reduce the body’s ability to form clots. For larger thrombi that pose an immediate danger, more potent medications known as clot-busting drugs are given. These break down blood clots, causing them to deteriorate. Unfortunately, they also present a high risk of hemorrhage.

A pulmonary embolism can be treated successfully. But treatment should be delivered as quickly as possible in order to minimize lung tissue damage. While death is rare, an untreated PE substantially increases the risk.

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