Blood clot in the lungs

Description

Pulmonary embolism or blood clot in the pulmonary artery (lung circulation). The clot typically sets off from the vein in the leg. The clot is growing, being stuck to venous wall and some its part or entire clot may separate, pass through the heart and then reach to the pulmonary artery. These arteries may progressively wane and the clot (embolism) is finally set in one of these arteries preventing the blood flow. These clots make inefficient lung circulation so that the lungs do not function properly. When the clot is very large it may quickly result in death. Risk for blood clots is increased with: recent surgical intervention, previous blood clots, cancer, immobilization, sitting position for longer period of time, contraceptive pills, surgeries and pregnancy.

Symptoms

Cough, shortness of breath, rib pain in breathing (pain in the pleura), chest pain, rapid breathing, rapid heartbeat, bluish skin coloration (cyanosis), weak pulse, and confusion.

Overview

Anamnesis will be taken and medical examination will be done. Tests are done, including lung X-rays, EKG (electrocardiogram) and ultrasound of veins in the leg. Diagnosis is confirmed by chest CT scan or more rarely by specialized test called ventilation and perfusion scan.

Tests

Complete blood count (CBC), biochemical blood analysis, D-dimer, electrocardiogram (ECG/EKG), troponin test, CT scan, ultrasound and X-rays.

Additional analyses

Prothrombin time (PT), partial thromboplastin time (PTT), chest CT scan angiogram (CTA), ventilation and perfusion scan, pulmonary angiogram.

Specialists

Hematology, Oncology, General Practic, Internal Medicine, Pulmology

Therapy

In majority of the cases pulmonary embolism requires hospitalization for initial treatment. Pulmonary embolism that directly endangers the patient’s life requires dissolution of thrombus (thrombolysis) with medicines: tissue plasminogen activator (t-PA), streptokinase or urokinase. Medicines for stabilization of the clots or prevention from occurring additional clots, are given, including: heparin, enoxaparin (Clexane) and/or warfarin (Farin). Urgent treatment may involve mechanical ventilation to maintain oxygen levels and pressors for raising the blood pressure.