Pulmonary Embolism (PE)

Pulmonary embolism, a complication of DVT, is a medical emergency arising as a result of dislodged DVT clot. This clot travels through the bloodstream and blocks one of the lung arteries, obstructing the blood flow there. These arteries carry deoxygenated blood from the heart to the lungs for oxygenation and their blockage can lead to low blood oxygen levels, lung damage, organ damage and even heart failure. A massive blockage can even be fatal.

Around 2 in 10 people with deep vein thrombosis develop a pulmonary embolism.

In some rare cases, an air bubble, fat droplet or other tissue can also cause PE.

Without treatment, a pulmonary embolism can be deadly in 30% of cases. Even in the case of survival, complete life expectancy and quality of life cannot be assured. Anyone who develops DVT is at risk of pulmonary embolism. It presents with the following symptoms:

• stabbing chest pain, which worsens with deep breath or cough.
• sudden cough which may contain blood.
• dizziness or even fainting.
• rapid shallow breathing.
• rapid irregular heartbeat.
• sweating.
• low blood pressure.

As the signs and symptoms of PE are similar to various other medical conditions, a detailed examination by an experienced physician is needed. The following steps will be taken to confirm the diagnosis:

• A pulmonologist and vascular surgeon will take your medical history and a physical examination.
• They will ask you if you've experienced any signs of deep vein thrombosis (DVT).
• They will perform the following confirmative diagnostic tests: USG, Spiral CT scan or CT angiogram, Ventilation-perfusion lung scan (VQ scan), Pulmonary angiography and D-dimer test.

If PE is confirmed, the following treatments are usually recommended - but Dr Abdullah considers all aspects of your unique case before he starts treatment:

• Anticoagulants (blood thinners) - Heparin, warfarin and newer anticoagulants (rivaroxaban and apixaban) decrease the size of the blood clot.
• Vena cava filter- a small metal filter is placed to catch the big clots and prevent them from entering the heart and subsequent lung vessels.
• Fibrinolytics break and dissolve the clot when given intravenously. Used only in life-threatening situations as it carries high risks of bleeding.
• Percutaneous thrombectomy - an x-Ray guided procedure which can either extract the clot or deliver medication directly to it.
• Surgery to remove the blood clot in severe cases.