Pulmonary Embolism or PE – Presentation To Diagnosis

Published on: 2017/12/10

Dr. Swetha, Intern, Sri Ramachandra Medical College, Chennai, India

Abstract

Review the incidence, symptoms and presenting signs of PE. To learn about clinical prediction models and also to learn about different diagnostic methods and diagnostic algorithms.

Interest Category

PE, Pulmonary Embolism

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A pulmonary embolism (PE) is primarily a blood clot that occurs in the lungs. It can cause damage to that part of the lung where the blood flow gets restricted. This, in turn, decreases the oxygen levels in the blood and thus affects other organs too.

Pulmonary embolisms can turn fatal if they are large or found in multiple numbers. It is estimated that death occurs in 1/3rd of the patients where this condition remains undiagnosed or untreated. Receiving immediate treatment can avoid permanent damage to the lungs.

Causes of PE

Pulmonary embolisms are often caused by blood clots that form in veins deep in the body. It is called deep vein thrombosis. These mainly occur in legs or the pelvis. The blood clots can occur due to injuries like fractures or muscle tears, which damage blood vessels causing clots. Long periods of inactivity may also be one of the reasons. Some medical conditions like a surgery or chemotherapy can also cause blood clots.

Symptoms of PE

The most common warning sign of pulmonary embolism is shortness of breath, which can be sudden or gradual. The other symptoms include anxiety, bluish skin tone, chest pain extending to the face, irregular heartbeat, dizziness, rapid heartbeat, weak pulse etc.

For years, pulmonary angiography has been the gold standard in the detection of pulmonary embolism. Today, computed tomography pulmonary angiography (CTPA) is the first line imaging test used for the detection of PE. D-dimer test is used alongside to determine the presence of PE.

Treatments for PE

Treatments for PE aim to prevent the existing blood clots from getting bigger and preventing new blood clots from forming. Primary treatments include giving anticoagulants or blood thinners. These are used to prevent new blood clots from forming.

Thrombolytic therapy is also used where the physician gives medicines to dissolve existing blood clots in cases that are life-threatening. Surgery is also an option for the removal of blood clots that restrict the flow of blood to important organs like lungs or the heart.

Pulmonary embolism can be avoided by applying preventive measures. The main aim is to stop blood clots from forming in veins deep inside the body. Patients who have undergone surgeries may be advised to use anticoagulants. Compression stockings are suggested post surgery to facilitate the movement of blood. Exercise is the best bet to keep blood flowing and the body healthy.