Pulmonary Embolism or Blood Clots in the Lung

Pulmonary embolism is a blockage in the blood vessels of the lungs. In most cases, the blockage occurs when a blood clot travels from a point downstream in the circulation and gets stuck, as the vessels become narrower in the lungs.

Pulmonary emboli are a problem for many patients following an operation. The most common site for a clot to form is in the deep veins of the leg (deep vein thrombosis), which detaches and is transported by the blood to a smaller vessel, which it then blocks.

When the clot plugs an artery in the lungs, the blood supply to the segment of lung beyond that point can collapse and die, forming an area of scar tissue. The degree of damage depends on the size of the artery blocked and whether or not an alternative way for blood to reach that area of lung exists. Some clots are so tiny and have so little effect on the lung that the person never knows that they have occurred. Larger or more extensive emboli are medical emergencies because they can rapidly lead to death. Small clots can enlarge once they plug an artery and gradually destroy larger and larger areas of lung.

When treatment is given quickly enough, most patients who survive the first hour following a Pulmonary Embolus will go on to live a normal life. Large areas of damaged lung may lead to a condition called cor pulmonale, a progressive failure of the right side of the heart.

RISK FACTORS
• Immobility from bed-rest, surgery, limb paralysis, etc.
• Injury to the vein through trauma or medical procedures
• Factors which increase the tendency of the blood to clot including malignant diseases, some drugs (contraceptive pill), dehydration, some kidney disorders and ulcerative colitis
• Ageing.

SYMPTOMS
• Sometimes there are no symptom
• Sudden chest pain
• Sudden shortness of breath
• Coughing of blood or pink-stained frothy mucus
• Collapse
• Fever
• Increased heart rate.

TREATMENT OPTIONS
Note: If you suffer from chest pain and shortness of breath, seek medical advice immediately. In no way is this information intended to replace the advice of a medical practitioner.
• Treatment must be sought as soon as possible. This prevents enlargement of the clot. Anticoagulants (medications that thin the blood) are often used immediately and then over the months following the pulmonary embolus. Drugs that can help dissolve the clot (thrombolytics) may be used in some cases. In rare cases where repeated clots are a problem, a small filter may be inserted to prevent the clots from travelling to the lungs.
• Some experts recommend that anyone with a higher risk of clots should have one low-dose aspirin tablet a day, to help keep the blood thin. Talk to your pharmacist to discuss the risks and benefits. Note: aspirin should not be given to children under 16 years of age unless specified by a doctor. Aspirin should be avoided in children aged 12 -15 if they are feverish.

PREVENTION
Preventing blood clots in the legs is an important step in preventing pulmonary emboli. This can include:
• Compression stockings
• Early mobilization after surgery
• Exercise
• Physiotherapy
• Drink plenty of fluids to keep well-hydrated and be aware that alcohol, tea and coffee can increase fluid loss from the body.
• Quit smoking
• Lose weight if necessary.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice
1. Your Pharmacy stocks a range of compression stockings which may help to reduce the risk of developing thrombosis by helping to improve the flow of blood in the leg veins.
2. Stop smoking. Smoking is a major risk factor for the development of thrombosis. A variety of products have been designed to make quitting easier and your MedAux Pharmacist can offer guidance and support.
3. Ask your Pharmacist for advice about healthy weight management.