Pulmonary embolism

Pulmonary embolism's disease overview

What is

What is pulmonary embolism?

pulmonary embolism is a condition of pulmonary artery blockage due to thrombosis from the deep vein system.

The thrombosis has been broken and freely floating in the blood vessels can move to another area of the body and cause clogged blood vessels there. There may be one or more thrombosis.

Normally all the veins in the body lead the blood into the vein larger, then lead the blood to the right heart and continue into the pulmonary artery. If there is a thrombosis in the vein system, this thrombosis will move from the veins to the right heart and then from the right heart to the main pulmonary artery and may be trapped there or continue moving into one of the two lungs.

When the thrombosis is in the pulmonary artery, the blood flow will be blocked to the lungs to get oxygen. If there is not enough blood to receive oxygen and move to the left heart, the oxygen concentration in the body is dangerous and can cause damage to all organs in the body, including the brain, the kidneys and heart.

In addition, due to obstruction in the lungs increases the pressure on the right heart. The right heart may be enlarged and more severe, even pinching, affecting the left heart. If the left heart cannot pump enough blood, blood pressure also drops. All of these effects can lead to sudden death or after pulmonary embolism has occurred for a short time without being treated.

Pulmonary embolism is a common and fatal disease with a mortality rate of about 30% if not treated. However, death can be significantly reduced by early diagnosis and treatment.

Causes of Pulmonary embolism's disease

Causes of pulmonary embolism include:

Pulmonary embolism mainly comes from deep vein thrombosis. In addition, it may come from pelvic veins, kidneys, upper limbs or right heart. Most of the thrombosis established slowly flowing blood like vein valves or venous sulfates.

A few cases of pulmonary embolism are not due to thrombosis but other causes such as:

Fat embolism

Due to foreign objects

Cancer

amniotic fluid (common in postpartum pulmonary embolism )

Infections

Symptoms of Pulmonary embolism's disease

Symptoms of pulmonary embolism include:

Difficulty breathing: Usually sudden onset

Stunned

Chest pain: can last from a few minutes to a few hours

tachycardia

Loss of consciousness

Hematuria vomiting

Low blood pressure

Sweating

Wheezing

Pale skin

People at risk for Pulmonary embolism's disease

Risk factors leading to pulmonary embolism include:

Elderly: 70 years old and older

Hyper coagulation disorders

There are vascular abnormalities such as varicose veins, veins pathology: cancer, heart disease (such as congestive heart failure, myocardial infarction, ...)

pregnancy or within 6 weeks after birth

Smoking

obesity

Take a train or a long-distance aircraft (> 4-6 hours) without standing and traveling around

Lying immobilized for a long time after surgery or serious injury

Use birth control pills or hormonal therapy

People with a history of thrombosis or venous thrombosis

Prevention of Pulmonary embolism's disease

Take the drug under the guidance of the doctor, do not arbitrarily take the drug without being indicated or arbitrarily quit smoking

Avoid lying too long or inactive

Maintain a reasonable weight

Try to keep your toes higher than your hips when lying or sitting

No smoking

Do not wear too tight clothes, causing blood circulation to be prevented

Treatment of early venous thrombosis is significant in reducing symptoms and preventing pulmonary embolism.

Prevention of recurrence: Using oral anticoagulant or aspirin (if intolerant or contraindicated for anticoagulants) for patients with deep vein thrombosis or cancer .

Diagnostic measures for Pulmonary embolism's disease

Diagnosis of pulmonary embolism is mainly based on risk factors, clinical and subclinical symptoms.

Risk factors

Medical disease hospitalized or restricting travel, orthopedic abdominal surgery, pregnancy, ...

Clinical:

Sudden respiratory symptoms: shortness of breath, fast breathing, chest pain, blood coughing, wheezing, ...

Symptoms of circulation: tachycardia, neck veins, hypotension, shock, ... Testing:

Regular tests: Helps to comprehensively evaluate patients

Quantify heart enzymes: BNP, Troponin for prognosis

Aortic blood

X-ray

ECG

Quantifying the concentration of D-Dimer in the blood: D-Dimer is a Fibrin product, the higher D-D-Dimer concentration is specific to the diagnosis of pulmonary embolism

Intensive test:

Varicular ultrasound of the lower limb: 50% of the pulmonary embolism has a lower vein thrombosis

CT scan of multi -pulmonary pulmonary slices is the most commonly used test to search for the cause of pulmonary embolism. In this test, the dye is injected into the veins of the hand or arm and the CT scanner is performed to find the thrombosis in the lungs

Radiatrics of perfusion air vents: detect incompatible with perfusion ventilation. Normal radiation helps eliminate diagnostic.

Owinging pulmonary blood vessel system: is an invasive test but is a gold standard for diagnosis of pulmonary embolism.

Distinguish diagnosis:

Pulmonary embolism with clinical diseases like many other diseases such as chronic lung disease, asthma, congestive heart failure, pneumonia, acute myocardial infarction , aortic aneurysm, primary pulmonary hypertension, pericarditis, cancer, pneumothorax, rib cartilage, ...

Pulmonary embolism's disease treatments

Emergency resuscitation treatment: respiratory resuscitation:

Artificial ventilation: indicated intubation, mechanical ventilation for patients with acute pulmonary embolism with shock, respiratory failure. Hemorrhagic resuscitation: .

Vascular drugs: indicated to patients with hypotension. Can use Dobutamine, combined with noradrenaline.

Patients with acute pulmonary embolism with shock, hypotension

Consider the treatment of patients with acute pulmonary embolism at a high level of death at a high average level and with hemodynamic disorders

Must revive the heart, but suspect the cause of cardiac arrest is due to pulmonary embolism

There is evidence of thrombosis spreading on a computer -layer film or a widespread usk on the pulmonary pulmonary ventilation

There is a mobile thrombotic in the right heart chamber

There is a condition of severe hypoxemia

Pulmonary embolism accompanied by heart defects exist oval hole

Dosage: The current recommended fiber pills are RTPA, intravenously continuously for 15 minutes with a dose of 0.6 mg/kg.

Time: Hematoma pepper is most effective when treated within 48 hours from the appearance of symptoms. However, it is still possible to consider indicating in patients with pulmonary embolism from 6 to 14 days.

Blood thrombotic surgery, or tip of the tip of the tip of the pipeline: Surgery should be combined with an echocardiography through the esophagus to fully assess the thrombosis of the lungs.

Indications:

There is a thrombosis in the oval, right or right atrial hole

The thrombosis is moving

Inverse pulmonary embolism

Antaginalism treatment

Use the lower a vein filter:

Indication:

Patients with acute pulmonary embolism but contraindicated for anticoagulant treatment

Patients with pulmonary embolism and/or deep vein thrombosis under recurrence Despite the optimal anticoagulant treatment

Patients with circulatory or severe respiratory failure are at risk of death if pulmonary embolism

See also:

Pulmonary embolism: Things to know

Overview of common diseases in the lungs

Diagnosis and treatment of pulmonary embolism

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