Description A blood clot in a pulmonary artery (the circulation of the lung.) Blood cl...
Description
A blood clot in a pulmonary artery (the circulation of the lung.) Blood clots typically start in a vein in the leg. A clot builds up stuck to the wall of the vein, and some or all of the clot can break off, pass through the heart, and then float into a pulmonary artery. These arteries get progressively smaller and the clot (embolus) eventually lodges into one of these arteries preventing blood flow. These clots make circulation through the lungs inefficient so the lungs do not work as well. When the clot is very large (called a saddle embolus) it can result in rapid death. The following increase the risk of blood clots: recent surgery, previous blood clots, cancer, being bedbound, sitting for prolonged periods of time, birth control pills, surgery and pregnancy.
Symptoms
Cough, shortness of breath, pain in ribs during breathing (pleuritic chest pain), chest pain, rapid breathing, rapid heart rate, blue discoloration of the skin (cyanosis), weak pulse, confusion.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. Tests including a chest x-ray, an EKG (electrocardiogram), and ultrasound of the veins in the leg are done. The diagnosis is confirmed with a CT scan of the chest or less commonly, a specialized scan called a ventilation and perfusion scan.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, D-Dimer, Electrocardiogram (EKG), Troponin, Ultrasound, X-ray
Other Specific Tests: PT (Protime), PTT (Partial Thromboplastin Time), CT angiogram (CTA) of the chest, ventilation and perfusion scan, pulmonary angiogram
Specialists:
Internal Medicine, Pulmonology, Family Practice, Blood and Cancer Care (hematology and oncology), Pediatric Pulmonology, Pediatric Hematology and Oncology
Workup:
A history and physical exam will be performed. Tests including a chest x-ray, an EKG (electrocardiogram), and ultrasound of the veins in the leg are done. The diagnosis is confirmed with a CT scan of the chest or less commonly, a specialized scan called a ventilation and perfusion scan.
Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, D-Dimer, Electrocardiogram (EKG), Troponin, Ultrasound, X-ray
Other Specific Tests: PT (Protime), PTT (Partial Thromboplastin Time), CT angiogram (CTA) of the chest, ventilation and perfusion scan, pulmonary angiogram
Specialists:
Internal Medicine, Pulmonology, Family Practice, Blood and Cancer Care (hematology and oncology), Pediatric Pulmonology, Pediatric Hematology and Oncology
Treatment
Most of the time, a pulmonary embolus requires a hospital stay for initial treatment. Immediate life-threatening pulmonary embolisms require dissolving the clot (thrombolysis) with a medication: tissue plasminogen activator (t-PA), streptokinase, or urokinase. Medications to stabilize the clot and to prevent further clots are given and include: heparin, enoxaparin (Lovenox), and/or warfarin (Coumadin). Emergency treatments may include mechanical ventilation to maintain oxygen levels, and pressors to increase the blood pressure.