A pulmonary embolism (PE) is a blood clot that develops in a blood vessel elsewhere in the body (often the leg), travels to an artery in the lung, and suddenly forms a blockage of the artery.
Thank you for reading this post, don't forget to subscribe!Blood moves through the veins back to the heart, flows slow. Sometimes this slower blood flow may lead to clot formation; Blood clotting is a normal process to prevent bleeding. The body makes blood clots and then breaks them down.
A blood clot that forms in a blood vessel in one area of the body, breaks off, and travels to another area of the body in the blood is called an embolus. An embolus can lodge itself in a blood vessel. This can block the blood supply to a particular organ. This blockage of a blood vessel by an embolus is called an embolism. A pulmonary embolism occurs when a blood clot reaches the lungs.
These blood clots often come from deep vein thrombosis, which can result from damage to bone and muscle or from long periods of inactivity. Many times the exact cause of a DVT or PE is unknown despite a thorough evaluation.
It can damage part of the lung due to:
- restricted blood flow
- decreased oxygen levels in the blood
- effects on other organs
Large or multiple blood clots can be life threatening.
Symptoms of a pulmonary embolism
Symptoms of a PE depend on the size of the clot and where it gets stuck in the lung.
The most common symptom of a PE is shortness of breath. This may be gradual or sudden.
Other symptoms include:
- anxiety
- clammy or bluish skin
- chest pain that may extend into your arm, jaw, neck, and shoulder
- fainting
- irregular heartbeat
- lightheadedness
- rapid breathing
- rapid heartbeat
- spitting up blood
- weak pulse
Causes of pulmonary embolism
Blood clots can form for a variety of reasons. PEs are most often caused by deep vein thrombosis (DVT), a condition in which blood clots form in veins deep in the body. The blood clots that most often cause PEs begin in the legs or pelvis.
Blood clots in the deep veins of the body can have several different causes, for example:
- Injury or damage. Injuries like bone fractures or muscle tears can cause damage to blood vessels, leading to clots.
- Inactivity. During long periods of inactivity, gravity causes blood to collect in the lowest areas of your body, which may lead to a blood clot. This could occur if you’re sitting for a lengthy trip or if you’re lying in bed recovering from an illness.
- Medical conditions. Some health conditions cause blood to clot easily, which can lead to PE. Treatments that involve surgery often lead to short-term bed rest or limited movement, which can make clotting more likely. Also, certain medical therapies for example, advise Vit-K along with anticoagulants especially Warfarin; Paracetamol, Ibuprofen, cancer drugs etc.
Diagnosis
PE has a wide variety of characteristics, ranging from no symptoms to sudden death. The most common presenting symptom is shortness of breath followed by chest pain and cough. However, many people with PE have mild or nonspecific symptoms or are asymptomatic, including people with a large PE.
A doctor should ask about overall health and any preexisting conditions patient may have and perform one or more of the following tests to discover the cause of the symptoms:
- Chest X-ray. This is a standard, noninvasive test that lets a doctor see patient’s heart and lungs to look for other obvious causes of the symptoms. A PE can not be diagnosed with this test. The most common finding of a PE on a chest X-ray is “normal.”
- Electrocardiography (ECG). An ECG measures patient’s heart’s electrical activity. A PE can not be diagnosed on an ECG. This test will check for other causes of chest pain.
- Computed tomography pulmonary angiography (CTPA). This test is the first-choice diagnostic imaging method because it’s sensitive and specific for the diagnosis of PE. It requires the use of intravenous (IV) contrast. Therefore, patients with kidney problems will likely not be able to have this test because contrast may cause or worsen kidney disease. When a CTPA can not be performed, the doctor may instead consider a ventilation or perfusion (VQ) scan to diagnose a PE.
- Ventilation/perfusion scan (VQ). A VQ scan is carried out in two parts. In the first part, radioactive material is breathed in, and pictures are taken to look at the airflow in patient’s lungs. In the second part, a different radioactive material is injected into a vein in patient’s arm, and more images are taken to see the blood flow in the lungs. This is mostly reserved for when:
- patient can not receive a CTPA
- the results of the CPTA were inconclusive
- more testing is needed.
- Magnetic resonance pulmonary angiography (MRPA). This is not recommended as a first-line test for diagnosing PE, but it may be an imaging option to diagnose PE in patients who can neither receive a CTPA nor a VQ scan. Potential advantages of MRPA are that no ionizing radiation is involved, and the examination can be combined with MR venography in the same sitting to look for DVT.
- Venography. A venogram is an invasive test that is rarely used for the diagnosis of only a DVT. This is a specialized X-ray of the veins in patient’s legs and also requires the use of contrast.
- Pulmonary angiography. A pulmonary angiography is an invasive test that’s rarely used to diagnose an acute PE. It involves making a small incision so a doctor can guide specialized tools through patient’s veins. The doctor will use contrast to see the blood vessels in the lung.
- Duplex venous ultrasound. This is a practical and noninvasive test to only diagnose a DVT. It’s important to remember that a person can still have a PE even if the ultrasound is negative for a DVT. This test uses radio waves to visualize the blood flow and check for blood clots in patient’s legs.
- D-dimer test. This is a type of blood test used to screen for signs of a PE or DVT based on the patient’s probability of having a clot. A doctor can not make a diagnosis based on this blood test. If the result is positive, the doctor must confirm the diagnosis with the appropriate imaging method.
Acute PE, a blockage in the lung artery, often from a blood clot, is a common and sometimes fatal disease. When a person evaluated for a PE, it’s often important for the evaluation to be efficient and avoid unnecessary testing so you can start therapy quickly.
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What are the risk factors for a pulmonary embolism?
Factors that increase risk of developing DVT and PE include:
- cancer
- a family history of embolisms
hypercoagulable states (blood prone to clotting) or genetic blood clotting disorders, including:
- factor V Leiden
- prothrombin gene mutation
- high levels of homocysteine
- a history of heart attack or stroke
- obesity
- a sedentary lifestyle
- taking estrogen or testosterone
Pulmonary embolism allopathic treatment
Treatment for a PE depends on the size and location of the blood clot. If the problem is minor and caught early, a doctor may recommend medication as treatment. Some drugs can break up small clots.
For example:
- Anticoagulants. Also called blood thinners, medications such as heparin and warfarin prevent new clots from forming in your blood. They can save life in an emergency situation. Another commonly used category of anticoagulant is the direct oral anticoagulants (DOACs), such as rivaroxaban and apixaban.
- Clot dissolvers (thrombolytics). These drugs break down a clot to improve blood flow and perfusion. They are reserved for patients hospitalized in emergency situations because sever side effects may include dangerous bleeding problems.
Minimally invasive procedures or surgery may be necessary if patient is unstable because of the problematic clots and need urgent reperfusion to improve blood flow to patient’s lungs and heart, especially when thrombolytics can not be used.
Some procedures an allopathic doctor may use in the case of a pulmonary embolism include:
- Catheter directed methods. These are used for clot removal and breakdown. A catheter will suction out, break down, or dissolve clots in patient’s pulmonary artery.
- Open surgery. Doctors use open surgery only in emergency situations when:
- minimally invasive catheter directed methods are not available.
- medications aren’t working to break up the clot.
- medications are contraindicated or carry too many risks for the patient.
Homeopathic Treatment for Pulmonary Embolism
Apis Mellifica
Abscess. Ankles, swelling of. Apoplexy. Dissection wounds. Dropsy. Ear, erysipelas of. Erysipelas. Erythema nodosum. Eyes, affections of; optic neuritis. Feet, burning of. Gangrene. Gout. Hands, swelling of. Heart, affections of. Heat-spots. Housemaid’s knee. Hydrocephalus. Hydrothorax. Injuries. synovitis. Meningitis. Ovaries pain in; inflammation of; tumours of. Panaritium. Pannus. Peritonitis. Phlebitis. Hydrothorax. Sensation of soreness in the chest, as from a bruise. Oppression of the chest, shortness of breath especially when ascending; inability to remain in a warm room. Dull aching pain in chest. Expectoration of copious, transparent, frothy, bloody mucus. Every shock from coughing gives pain in the head and some pain through the chest. Sudden pain just below the heart, soon extending toward. violent beats, shaking the whole body; intermittent beats. Region of heart sensitive to least pressure; rasping sounds of systole and diastole unmistakably audible. Palpitation of heart from scanty secretion of urine, perfectly cured by establishing the natural quantity. Pulse: almost imperceptible at wrist; accelerated and full; very frequent and hard; wiry; irregular and slow pulse; intermittent.
Arnica
Dry, short cough, produced by a titillation in the larynx. Cough with bloodshot eyes, or nose-bleed. Even yawning provokes a cough. Hemoptysis (Cough with expectoration of blood); the blood is clear, frothy, mixed with coagulated masses and mucus. On coughing, shooting pains in the head, or a bruise-like pain in the chest. Respiration short, panting, difficult, and anxious. Rattling in the chest. Shootings in the chest and sides, with difficulty of respiration, aggravated by coughing, but breathing deeply, and by movement; better from external pressure. Beating, and palpitation of the heart. veins of hands swollen, purplish; sudden pain as if heart squeezed or had got a shock (angina pectoris). Heart strained; irritable; stitches in.
Secale Cornutum
Heavy, anxious breathing, with moaning.-Spitting of blood, with or without cough. Feeble voice, inaudible, stammering. Expectoration of blood during violent efforts to breathe. Anxious and obstructed respiration, with sighs and sobs. Dyspnoea and oppression of chest. Suffocating oppression of chest, with cramp in diaphragm. Praecordial tenderness. Painful sensation over heart. Praecordial anxiety. Violent spasmodic palpitation. Pulse small, very rapid, contracted; frequently intermittent; fluttering, slow, depressed.
Phosphorus
Cough excited by a tickling and itching in chest. -Hollow, hacking, spasmodic, tickling cough, especially if caused by tickling in chest. Cough with stitches over one eye. Dry, shaking cough, with sensation as if head were going to burst. Cough in paroxysms, brings up a viscid, muco-purulent expectoration, branched like the bronchial tubes, pale red, rust-coloured, streaked with blood. Noisy and panting respiration. Difficult respiration. Respiration oppressed, quick, anxious. Spasmodic asthma. Constrictive spasms in chest. After a cough, asthma. Fits of suffocation. Rush of blood to heart and palpitation, that becomes very violent after eating. Palpitation of heart of different kinds, especially after a meal, morning and evening, when seated and after all kinds of mental excitement. Palpitation of heart with obstructed respiration; palpitation from every mental emotion. Violent palpitation with anxiety, evenings and mornings in bed; on slight motion. Blowing sounds in heart. Pressure in middle of sternum and about heart. Pulse rapid, full, and hard; small, weak, easily compressed.
Carduus Marianus
Irritation in posterior part of larynx causing cough. Expectoration: pure blood; mucus mixed with blood. Drawing pain under ribs. Pain during breathing. Cough with stitches in sides of chest and bloody sputum. Splenic or hepatic cough. Pains in chest, going to front part, to shoulders, back, loins, and abdomen combined with urging to urinate. Pain pressure and stitches in region of heart; oppression on deep breathing.
Salicylicum Acidum
Respiration hurried, sometimes deepened, sometimes shallow or sighing and almost panting, as if laboured, but no complaint of difficulty of breathing.-Dry cough of a hard, racking, spasmodic character. Spasmodic, flatulent asthma; fetid bronchitis; gangrene of lungs. Pulse small, rapid, weak.
Bothrops Lanceolatus
Haemorrhages, the blood being fluid and black. Pulmonary congestion, oppressed breathing and bloody expectoration, more or less profuse. Paralysis of arm or leg. Deep gangrene, bones laid bare and necrotic. Hemiplegia. Dissecting gangrene. Slight shivering followed by very profuse cold sweat.
Convallaria Majalis
Fluttering at heart, lasting about a minute, then face would get red, with sensation as if heart stopped beating and would start again very suddenly, with faint, sick feeling.-Pulse full, compressible, intermittent. Pulmonary congestion. Orthopnea. Dyspnoea while walking. Endocarditis, with extreme orthopnea. Sensation as if heart ceased beating. Angina pectoris. Extremely rapid and irregular pulse.
Naja
Short, puffing cough, every minute. Dry, hacking cough; blood-spitting. Expectoration of whitish viscid mucus. Spitting of blood. Respiration very slow; shallow, and scarcely perceptible; laboured and difficult; gasping for breath. Heavy pain in chest. Lancinating pains, feels better on deep inspiration. Asthmatic constriction of chest; cannot expand lungs; followed by mucus expectoration. Heavy pain over lower half of chest, with stabbing on deep inspiration; cannot cough for the stabbing. Dull pain of sternum. Tenderness over sternum. Feeling of depression and uneasiness about heart. Severe pain in region of heart. Fluttering and palpitation of heart. Audible heart beating. Pulse slow and irregular in rhythm and force; weak and thready, scarcely perceptible. Pulse rapid; and full; 120, some beats tolerably full and strong, afterwards 32, irregular in rhythm and force, some of the beats full and bounding.
Belladonna
Cough with stitches in the chest, in the lumbar region, in the hip, in the uterus; pain in the sternum, with tightness of the chest; with rattling of mucus on the chest. Dry spasmodic cough, with vomiturition. Whooping-cough, with crying, or pain in the stomach before the attack, with expectoration of blood (pale or coagulated), congestion of blood to the head, sparks before the eyes, spasms in the throat, bleeding from the nose, stitches in the spleen, involuntary stool and urine, oppressed breathing, stiffness of the limbs, shaking of the whole body, and dry general heat. Breathing laboured, unequal, quick, with moaning. Rattling noise, and crepitation in the branchia. Vehement expirations. Feeling of suffocation when swallowing, or when touching and turning the neck. Oppression of the chest, difficult respiration, dyspnoea and shortness of breath, sometimes with anxiety. Congestion to the chest. Irregular respiration, at one time small and rapid, at another time slow and profound. Respiration short, anxious, and rapid. Violent beatings of the heart. Trembling of the heart, with anguish and pressive pain.
Vipera communis
Suffocation. Dyspnoea; with sticking in heart. Anxious breathing, threatening asphyxia. Breathing ceased suddenly, heart stopped, face became livid. Blood drawn from arm flowed scantily, was dark, mixed with bright streaks. Veins of chest and abdomen thick and hard. Swelling of chest and/or umbilicus. -Edema of lungs before death. Pain in chest; over the ribs on pressure. Oppression, with anxiety; with violent efforts to breathe and swallow.
Sticking in heart; with cold sweat and faintness. Pain in heart with faintness. Dragging pain, becomes faint. Anxiety. Heart’s action: slow; feeble; and no pulsation in radial or carotid arteries, but that in crural was very strong. Pulse: rapid; interrupted; slow, febrile; irregular; weak. Vipera is a very valuable medicine for varicose veins and for acute phlebitis, the vein is swollen, bordered by an area of inflammation, very sensitive to touch, but particularly with the sensation, on letting the leg hang down, as if it would burst from the fulness of the veins.
Aesculus Hippcostanum
Short cough, increased by swallowing and breathing deeply. Hoarseness. Raw feeling in chest. Tightness in chest. Abundant raising of mucus in morning. Cough, with sensation of stiffness in the throat and suffocation in the upper chest. Oppression, stitches, soreness and other troubles of chest. Catarrhal affections causing hoarseness and cough. Twitching over region of heart. Stitches and neuralgic pains in region of heart and forehead. Functional disturbances of the heart from haemorrhoidal complaints.
Hamamelis Virginica
Tickling cough, taste of blood on awaking. Dry cough, severe stinging in the uvula, as if it would break. Expectoration thick, yellowish or greenish grey, tasting putrid. Haemoptysis (tickling cough with blood). Tightness of the chest; cannot lie down, because of difficult breathing from congestion; fullness in the head. Stitches in lower part of lungs.-Sensation of constriction across chest. Palpitation. Pricking pain in region of heart and superficial veins of both arms.
Aurum Metallicum
Accumulation of mucus in the trachea and in the chest, which is expectorated with difficulty in the morning. Voice nasal. Cough from want of breath at night. Cough with tough yellow sputum on awaking. Great difficulty of respiration, requiring deep inspirations. Paroxysms of suffocation, with constrictive oppression of the chest, falling, loss of sense, and bluish colour of the face. Pain, as if there were a plug placed under the ribs. Continuous aching in the chest. Incisive pain, and obtuse shootings, near the sternum. Great weight on chest. Much congestion in the chest.
Anxious heart palpitation, from congestion to the chest. Beatings of the heart, irregular, or by fits, sometimes with anguish and oppression of the chest. Pain in heart region extending down arm/to fingers. Floundering heart. When walking, the heart seems to shake as if it were loose. Sensation as if the heart stood still. Palpitation compels patient to stop.
Lachesis
Catarrh, with cough, coryza, shooting pains in head, stiffness of nape of neck, and affection of chest. Oppressed breathing. Sensation of pulsation and of choking between larynx and chest. Cough with rawness of chest, difficult expectoration. Frequent attacks of short cough from tickling in pit of stomach. Haemoptysis. Respiration short, frequent, or convulsive or rattling, stertorous, and croaking, or wheezing, moaning, and deep. Frequent want to draw a long breath. Dyspnoea and oppression of the chest, with effort to breathe. Shortness of breath. Fits of suffocation. Paralytic orthopnoea. Offensive slow, heavy, wheezing breathing. Extravasation of blood in lungs. Pneumonia. Gangrene of lungs. Swelling and bloatedness of integuments of chest. Itching, red places, and miliary eruption on chest.
Palpitation of heart and choking from slightest anxiety. Irregularity of beats. disagreeable pulsation in ears. Stitches in region of heart, with shortness of breath, fainting fits and cold sweat.
Secal Cornutum
Heavy, anxious breathing, with moaning.-Spitting of blood. Expectoration of blood during violent efforts to breathe. Anxious and obstructed respiration, with sighs and sobs. Dyspnoea and oppression of chest. Suffocating oppression of chest, with cramp in diaphragm. Praecordial tenderness. Painful sensation over heart. Praecordial anxiety. Violent spasmodic palpitation of heart. Pulse small, very rapid, contracted; frequently intermittent; fluttering, slow, depressed.
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Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS) ; senior research officer Dnepropetrovsk state medical academy Ukraine; is a leading Homeopathic physician practicing in Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.
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