Pulmonary embolism

Pulmonary embolism

Description pulmonary embolism

Pulmonary embolism (PE) is a generic term for obstruction (obstacle) in pulmonary arterial (artery) stream usually a blood clot (rare another matter), which is brought by the blood stream.

Originally pulmonary embolism is from 80 to 90% of acutevenous thrombosis of the lower extremities. Venous thrombosis of lower extremities is currently very common. It is the formation of a thrombus (blood clot – hence thrombosis) in blood vessels having a weakened vascular wall.

This weakening occurs gradually age, family history, but also employment standing, smoking, etc. Vascular wall veins in the legs so permit, the veins lose their elasticity (flexibility) forms in them “bend”, which is to reduce the flow blood and therein begin to settle elements of the blood (particularly blood platelets).These sediments – clots and sudden increase in blood pressure (eg sharp movement) and pluck along with the blood travel through the body until they get into the lungs, where it is re-oxygenate the blood and clog are one of the pulmonary arteries.

Pulmonary embolism is recently very frequent postoperative complication after major surgery – abdominal, pelvic and lower limbs (usually within 1-2 weeks after surgery), when the patient during this period suddenly collapses, first of all need to think of a pulmonary embolism.

Pulmonary embolism is one of the other diseases that can quickly get out of control and death of the patient. Emboli in the pulmonary artery occurs hypoxemia (a lack of oxygen in the tissues) thereby causes tachypnea (rapid breathing), and thus follows hypocapnia (reduced carbon dioxide levels in the body – in the rapid breathing breathe more than inhaled).

In chronic heart disease is the possible manifestation not only of acute pulmonary embolism, but chronic embolism (blockage of a blood vessel embolism) when, especially in the riverbed of small and medium-sized pulmonary arteries penetrate small emboli, a frequent repetition of this situation gives rise to chronic pulmonary heart (cor pulmonale chronicum).

Percent of the rest of pulmonary embolism may occur different kind of material than blood clot. Of these materials, it can be accumulated tumor cells, as well as amniotic fluid – formerly a frequent complication during a difficult birth, foreign bodies – usually pieces of material during infusion syndrome fat embolism – a dangerous complications, especially in severe fractures of large bones, or orthopedic operations and air embolism, which can occur for example when an accident neck injury large veins or as a complication of the surgery.


Risk factors for pulmonary embolism

Risk factors for pulmonary embolism are mostly already past or current illness. This includes mainlyvenous thrombosis of lower extremities (rarely it may be at the upper extremities or in cavities of the right heart).

This is related to old age, family history, and especially smoking. Furthermore, unhealthylifestyle, low physical activity, frequent and long standing.

All this entails a risk of high pressure (hypertension), atherosclerosis (vasoconstriction settling mainly fat), which lead to venous thrombosis and consequently pulmonary embolism.

For women, a major risk factor for oral contraceptive use and smoking cigarettes while venous thrombosis of lower extremities. Risk factors include pregnancy.


Prevention of pulmonary embolism

Basic prevention is maintaining a healthy lifestyle – avoiding obesity, smoking, eating lots of fruits and vegetables, active sports – and avoid long standing.

If you have become (for example at work) is often a good idea to browse and to practice with the legs and sometimes the rub.

Another part is an already manifest sign of venous thrombosis in the legs to follow the doctor’s instructions and taking medications with anti srážlivými effects (in the hospital is the most commonHeparin, patients at home are taking warfarin – patients with these drugs must be regularly supervised by a blood test, because at higher doses would bleeding may occur).

These basic steps can be avoided Rapture thrombus, which passes through the lungs. Just before surgery as prevention employing elastic contractive stockings which are take off during the first steps after surgery. They give, because surgery is one of the other causes of pulmonary embolism.Stockings are used in the long term when extensive venous thrombosis of the lower extremities.


Signs and symptoms of pulmonary embolism

Pulmonary embolism is characterized by a sharp, biting pain in the chest, which is congested in a small thrombus easily localized – the patient indicates the exact point of pain and thus the obstruction site (obstacles). With a large thrombus pain it is rather extensive in space.

The patient feels great anxiety and stress, which results from his fear for his life, since it difficult to breathe. Other symptoms include shortness of breath, hemoptysis (coughing up blood), hypotension (low blood pressure), tachycardia (increased heart rate), pallor to cyanosis (Blueness – mainly in large embolus), sudden loss of consciousness, jugular vein distension, sweating.

When massive pulmonary embolism leads to cardiac arrest or shock.

Less marked symptoms usually mean smaller percentage of lung disease, and thus a greater chance to heal.

Doctors diagnose the disease by imaging methods such as – electrocardiogram (ECG), X-ray (RTG), computer tomography (CT) or – analysis of blood gases. On the imaging is beneficial to accurately determine the position of an embolus or to exclude this diagnosis. When nepomáhání pharmacological treatments are then used to precisely locate during surgery.


Treatment of pulmonary embolism

The first treatment usually begins with the arrival of ambulance service, which promptly begins with artificial ventilation (connection to the patient after the introduction of oxygen, intubation – tube into the airways) and pharmacological therapy and rapid transport to the hospital. Treatment is always in the hands of doctors at the hospital. At home, usually by ourselves we can hardly detect pulmonary embolism and certainly not cure it yourself.

The treatment is undoubtedly crucial applications depressant doses of strong analgesics(painkillers), medical treatment, inhalation of oxygen, fibrinolytic therapy (upset emboli drugs diluting structure emboli) in the last row are coming with surgical treatment, which is embolectomy(removal of emboli excision) .


How can I help myself

If you recognize the man himself wearing or the person in the vicinity symptoms of pulmonary embolism, must immediately call emergency medical help ensure symptomatic treatment and reduce pain.

When a major operation to air pulmonary embolism always remember. First aid at the hall may be correct patient positioning. Important for air embolism is positioning the patient in position on the left side and upside down so that the air accumulated in the right atrium heart, where it can then be removed by suction best doctor.

You can prevent a rapid convalescence after surgery, exercise, use of antiplatelet drugs in the treatment of (Anopyrin, warfarin – anticoagulant effects).


Complications of pulmonary embolism

Severe illness or massive embolism increases the likelihood of death by up to 30%.

Complications may also be bleeding events during anticoagulation therapy (antiplatelet agents – see above), which can dilute the blood and lead to unstoppable bleeding. Then, even a small wound, usually life-threatening, can cause bleeding.

Certain chronic diseases of the heart and vessels leading to chronic and recurrent risk of pulmonary embolism.

Other names: embolism, PE, acute pulmonary embolism, chronic pulmonary embolism, pulmonary embolism

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