Pulmonary Embolism: What It Is, Symptoms, Diagnosis, and Treatment

Pulmonary embolism, also known as lung embolism, refers to the blockage of blood vessels in the lungs for various reasons. It typically occurs when a blood clot from the legs or another part of the body travels through the bloodstream and blocks the pulmonary artery. This disrupts blood circulation in the lungs, creating problems in delivering oxygen to the cells and can lead to significant respiratory issues.

What is Pulmonary Embolism?

Pulmonary embolism is the blockage of the pulmonary arteries by a clot or other material. It usually arises from a clot that forms in another part of the body (most commonly from deep vein thrombosis in the legs) and travels through the bloodstream to the lungs. This blockage causes narrowing or obstruction of the pulmonary arteries, preventing sufficient blood from reaching the lung tissue. Pulmonary embolism can affect the lungs' oxygen exchange and lead to serious respiratory problems. Additionally, a clot in the lung tissue can disrupt the normal function of the lungs and cause issues in the circulatory system between the heart and lungs

What Are the Symptoms of Pulmonary Embolism?

The symptoms and severity of pulmonary embolism can vary depending on the size and number of clots and the patient’s overall health. The main symptoms of pulmonary embolism include:

• Sudden onset of severe chest pain
• Shortness of breath (especially worsening with exertion)
• Rapid breathing
• Palpitations or rapid heart rate
• Cough (which may be blood-streaked)
• Weakness and dizziness

What Causes Pulmonary Embolism?

Pulmonary embolism typically occurs as a result of a combination of the following factors:

• Deep Vein Thrombosis (DVT): DVT is the formation of a clot in the deep veins, usually in the legs. These clots can travel through the bloodstream to the lungs, causing pulmonary embolism.
• Immobility: Prolonged periods of immobility, such as being bed-bound for long durations, long flights, or car journeys, can lead to slowed blood circulation and clot formation.
• Surgical Procedures: During or after surgical procedures, patients may remain bed-bound or have restricted mobility, which can contribute to clot formation.
• Trauma and Fractures: Severe injuries, fractures, or trauma can increase the likelihood of clot formation in damaged areas of the blood vessels.
• Cancer: Cancer can lead to the release of certain substances that affect blood clotting, thereby facilitating clot formation.
• Pregnancy: Changes in hormone levels during pregnancy can cause blood to clot more easily and increase the risk of pulmonary embolism during this period.
• Heart Failure: Heart failure can prevent the heart from effectively pumping blood, leading to slowed blood flow in the vessels and clot formation.

How is Pulmonary Embolism Diagnosed?

The diagnosis of pulmonary embolism (PE) is made through a combination of symptoms, medical history, and various tests. Diagnosing PE is an emergency medical situation that requires prompt attention. Some common methods used to diagnose PE include:

• Physical Examination: The doctor gathers information about the patient's symptoms and performs a physical exam. They listen to the heart and lung sounds and evaluate symptoms during the examination.
• Anamnesis (Medical History): A medical history is taken, considering factors such as the patient's previous health status, past clotting issues, immobility, surgical history, and pregnancy history.
• Blood Tests: A blood test called D-dimer can indicate the presence of clot formation in the body. However, the D-dimer test alone is not sufficient for a definitive PE diagnosis and requires additional testing.
• Imaging Techniques:
  • Chest X-ray: While it may show signs of changes in the lungs related to clots, it is not sufficient for a PE diagnosis.
  • Spiral Computed Tomography (CT): This is the most commonly used imaging method for diagnosing PE. It can detect clots and obstructions in the pulmonary arteries.
  • Ventilation-Perfusion Scintigraphy (VQ Scintigraphy): This assesses the distribution of air and blood flow in the lungs and helps evaluate the likelihood of PE.
  • Pulmonary Angiography: This method is used for the most accurate diagnosis of PE. It involves injecting a contrast agent through a catheter to obtain detailed images of the pulmonary arteries.

What Are the Treatment Methods for Pulmonary Embolism?

The treatment for pulmonary embolism (PE) aims to dissolve the clot, prevent the growth of existing clots, and prevent new clots from forming. The treatment plan is determined based on the severity of PE, the patient’s overall health status, and other medical conditions. Treatment methods for pulmonary embolism include:

• Anticoagulants (Blood Thinners): Anticoagulant medications help reduce the blood's ability to clot, preventing further clot formation. Medications can be administered via injection, such as heparin and low molecular weight heparin, or taken orally, such as warfarin. Heparin acts quickly and is usually started during hospital admission. Warfarin is used for long-term treatment and requires regular blood tests.
• Thrombolytic (Fibrinolytic) Therapy: If PE is severe or life-threatening, doctors may use thrombolytic medications. These drugs help dissolve clots. Thrombolytic therapy is typically administered intravenously and often monitored in a hospital due to the risk of bleeding.
• Surgical Embolectomy: In rare cases, emergency surgical intervention may be required for PE treatment. This involves physically removing large clots from the pulmonary artery through surgical embolectomy.
• Filter Placement: In some cases, a device called a vena cava filter may be inserted to prevent large clots from traveling to the lungs.
• Supportive Care: If the patient requires respiratory support and oxygen assistance, supportive treatments are provided.

How Should Nutrition Be for Pulmonary Embolism?

A healthy nutrition plan for patients who have experienced pulmonary embolism (PE) can support recovery and help the body function properly. Nutrition is essential for PE treatment and overall health. Here are some dietary recommendations for patients who have had PE:

• Diet with Low Venous Occlusion Potential: Since PE arises from vascular occlusion, it is important to limit or avoid foods rich in salt, saturated fats, trans fats, and cholesterol. These are usually found in processed foods, fatty meats, processed snacks, and fast food products.
• Adequate Fluid Intake: Drinking plenty of water can help regulate blood circulation and prevent blood clotting. Water keeps the body hydrated and reduces blood clotting. However, it is also important to manage salt intake to prevent water retention in the body.
• Low-Dose Aspirin: For some patients, doctors may prescribe low-dose aspirin. Aspirin can help reduce blood clotting but should only be used on the recommendation of a doctor, as it may have side effects or interact with other medical conditions.
• Healthy Fats: Incorporating healthy fats into your diet, such as those found in fish rich in omega-3 fatty acids, avocados, olive oil, and nuts, can be beneficial. Omega-3 fatty acids help protect blood vessels and heart health.
• Fiber-Rich Foods: Foods high in fiber, such as fresh fruits, vegetables, whole grains, and legumes, can help regulate cholesterol levels and improve digestive health.
• Vitamin D and Vitamin K: While vitamin D increases calcium absorption, vitamin K contributes to blood clotting. Therefore, it is important to maintain a balanced intake of vitamin K while obtaining vitamin D from sunlight or supplements.
• Supplements: You may need to take vitamin and mineral supplements recommended by your doctor during treatment.

What Should Not Be Consumed in Pulmonary Embolism?

The nutrition plan for patients with pulmonary embolism should be adjusted based on medical treatment and overall health. It is important to avoid or limit the following foods and beverages during PE treatment:

• High Salt Foods: High salt intake can lead to water retention in the body and increased blood pressure. This can negatively affect vascular and heart health. Salty snacks, processed foods, canned products, and ready-made sauces can contain high amounts of salt.
• Saturated and Trans Fats: Saturated and trans fats can raise cholesterol levels and increase the risk of vascular occlusion. These types of fats are found in red meat, full-fat dairy products, processed snacks, and fast foods. Therefore, it is important to limit sources of saturated fats like butter and margarine.
• Excessively Sugary Foods and Drinks: Excessive sugar consumption can raise insulin levels and cause fluctuations in blood sugar. It is important to limit the intake of sugary beverages, sweetened snacks, and desserts.
• Excess Cholesterol Foods: It is important to limit foods high in cholesterol. These are typically found in animal-based products such as red meat, egg yolks, and processed snacks.
• Foods High in Vitamin K: If anticoagulant medications are used during treatment, it is important to limit or balance the intake of foods containing vitamin K, which affects the blood’s ability to clot. These are usually found in green leafy vegetables (like spinach, broccoli, cabbage) and some vegetable oils.

What is an Emboli Stocking?

An emboli stocking, also known as a compression stocking, is a special medical stocking used to reduce the risk of deep vein thrombosis (DVT) or to prevent the formation of pulmonary embolism (PE). The emboli stocking is designed to promote better blood circulation in the legs and prevent blood pooling. The stocking compresses the muscles and veins in the legs, helping to increase venous return (the return of blood to the heart) and reduce blood pooling and clot formation in the legs. Emboli stockings are typically used during prolonged bed rest, surgical operations, or for individuals at risk of DVT, especially during long travels. They can also be used for individuals with swelling or circulation problems in the legs.