A pulmonary embolism is a condition in which one or more arteries in the lungs become blocked by a blood clot. These blockages reduce the blood flow through the heart and lungs, making it more difficult for the lungs to provide oxygen to the body. Eventually, it can progress to decreased oxygen levels and low blood pressure.
The blockage of blood flow also puts a strain on the heart’s pumping mechanism since it is unable to push the blood past the clot. In severe cases, heart failure may occur and can lead to a fatal event. It is estimated that pulmonary embolisms cause 100,000 deaths each year, according to the American College of Cardiology.
Patients with pulmonary embolisms may experience:
Chest pain that worsens with breathing.
Lightheadedness or fainting.
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The most common cause of pulmonary embolism is blood clots, known as deep vein thrombosis or DVT, that travel from the lower body up to the lungs. Patients with deep vein thrombosis may experience swelling, tenderness, or discoloration of the legs.
Risk factors for pulmonary embolism include family history, cancer, blood-clotting disorders, being overweight, smoking, recent surgery, a sedentary lifestyle as well as certain types of hormone replacement therapies and birth-control pills.
A frequent test performed to diagnose a pulmonary embolism is a CT Scan. This is a special kind of X-ray that uses contrast to visualize the blood vessels.
Blood thinners are the common treatment for pulmonary embolism and DVT. They will not break down existing clots but are necessary to prevent new clots from forming. The body has natural mechanisms for breaking down clots, but this process can take weeks to months.
The FlowTriever device is a minimally invasive, catheter-based device that is available at McLeod Regional Medical Center to remove blood clots from the lung arteries. It allows for more rapid treatment of pulmonary embolism in many higher-risk patients.
The procedure is performed in the Cardiac Catheterization Laboratory by an Interventional Cardiologist who inserts the FlowTriever catheter into one of the leg veins. The FlowTriever is advanced over a carefully positioned wire to the lung arteries where the clot can be aspirated, or suctioned, into the catheter and removed from the body. In some cases, self-expanding, soft mesh disks can be used to improve removal of the clot.
With the removal of the clots, the procedure improves blood flow to the lungs, and often provides rapid improvement in shortness of breath, oxygen levels, blood pressure, and heart rate.
Patients who are admitted with a diagnosis of pulmonary embolism at elevated risk may be evaluated by an interventional cardiologist, a pulmonologist who specializes in lung care, and a vascular surgeon to determine the best course of treatment.
It is common for patients diagnosed with pulmonary embolism to also have a deep-vein thrombosis clot. In some cases, with a large amount of clot, a patient may be evaluated for a similar clot removal procedure or placement of a filter to prevent further clots from going to the lungs. For patients needing care for deep-vein thrombosis at McLeod Regional Medical Center or McLeod Health Seacoast, McLeod vascular surgeons are experienced in the ClotTriever and filter devices. The ClotTriever is similar to the FlowTriever device but is specific for the removal of blood clots in the lower body and legs.
Regular exercise is the best prevention for pulmonary embolism. If bed rest, recovery from surgery, or extended travel keeps you from walking around, it is important to move your arms, legs, and feet including tightening and relaxing your muscles for a few minutes every hour. Plan ahead if you know you will be sitting or standing for a long time. Talk to your doctor about wearing graduated compression stockings, which steadily squeeze the legs helping the veins and leg muscles move blood more efficiently.
Pulmonary embolism and DVT are common and can be life-threatening. Anyone with unexplained shortness of breath, chest pain or a bloody cough should seek medical care right away.
Dr. Brian Blaker is an interventional and structural cardiologist with McLeod Cardiology Associates. Dr. Blaker serves as the medical director of the McLeod Structural Heart Program. Structural heart disease can be present at birth or develop with age. It refers to defects in the heart’s valves, walls or chambers.
The McLeod Structural Heart Program specializes in percutaneous (minimally invasive) and surgical treatment of patients with a variety of heart disease, including patients who do not qualify for conventional open-heart procedures. Examples of minimally invasive treatments include transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis, MitraClip for the treatment of mitral regurgitation, and ASD/PFO closure.
Physician and self-referrals are welcome by calling 843-667-1891.