What You Need to Know About Pulmonary Embolism, the Killer Blood Clot

By Dr. Joseph Turyabahika, a senior consultant surgeon

Pulmonary Embolism (P/E) happens when blood clot gets lodged in an artery in the lung blocking blood flow to that of the lung. It starts in the leg and moves up to the right side of the heart into the lungs. (DVT).

It varies depending on the size of the clot, the size of the lung involved and Underlying heart or lung disease

How Pulmonary embolism presents:

Shortness of breath appears suddenly and gets worse on extension; Chest Pain is sharp and is worse when you breath in deeply. You can also fail to take a deep breath. It is worse when bend or one coughs; Cough produces blood or blood stained sputum; Rapid or irregular heart beat; Headache or dizziness x Excessive sweating; Fever; Leg pain/swelling usually in the calf (DVT); DVT -from the legs

What are the factors that increase the risk?

While anyone can develop blood clots and get PE, certain factors in crease the risk. They include: Previous PE/DVT of any family member with DVT 2 Heart disease e.g. Heart failure through masses clot formation more likely; Cancer especially Brain, Ovary, Pancreas, Colon, Stomach, Lung and kidney cancers; Cancers that have spread; Chemotherapy; Women with a personal or family history of breast cancer using tamoxifen; Surgery; major surgery, orthopedic and pelvic surgery; Disorders that affect clotting -DVT e.g. kidney disease PCRV; COVID -19 has increased risk of P/E; Prolonged immobility -bed rest after surgery, patients with fractures; Under weight; Normal weight; Over weight; Obesity class I; Obesity class II; Obesity class III; Supplemental Estrogen e.g. birth control pills Hormone Replacement therapy if you have risk factors (smoking & obesity); Pregnancy -weight of the baby slows blood hormones.  

Complications

P/E is life threatening – 1/3 of the people remain undiagnosed

Severe P/E can lead to death. When diagnosed early –survival is assured.

Pulmonary hypertension-blood pressure in the lungs and right side of the heart is too high. So the heart works too much to push blood through the legs and eventually weaken the heart.

Chronic pulmonary hypertension/chronic thrombi embolic pulmonary hypertension.

How can P/E be prevented

Blood thinners (anti-coagulants) e.g. heparin, clexane, used in hospitals to prevent clot formation.

Compression stockings – these steadily squeeze the legs helping veins & muscles to move blood more efficiently. safe, simple avoid stagnation. Leg elevation -this helps move blood back to the heart and stop clotting.

Physical activity- move as soon as possible after surgery. Nurses are good at this activity.

* Pneumatic compression – Using automated blood pressure machines inflate and deflate automatically they cast muscles and squeeze the veins in the legs and improve blood flow.

Prevention while travelling

Drink plenty of water-to avoid dehydration, it will help also to make you stop and stretch your back to pass urine; Take a break from sitting , move around the air plane cabin or stop the car and move out to stretch the legs; Avoid alcohol which can dehydrate; Fidget in your sit –fix your ankles every 15-30 minutes; Wear support stockings especially those with risk factors. Compression stockings are now available in pharmacies and in different sizes and colours.

Dr. Joseph Turyabahika was presenting during the 26th ICPAU annual seminar