Pulmonary embolism

Definition Pulmonary embolism : 
Pulmonary embolism (Pulmonary Embolism) is blockage of the pulmonary artery (pulmonary artery) by an embolus that occurs suddenly.
pulmonary embolism

CAUSE
Most of pulmonary embolism caused by a blood clot from a vein. Less common causes are air bubbles, fat, amniotic fluid, or clumps of parasites or tumor cells.

The cause of the blood clot may not be known, but many obvious risk factors, namely:
* surgery
* Bed rest or no activity for a long time (such as sitting while traveling by car, plane or train)
* Heart problems, for example heart failure
* Obesity (overweight)


* cancer
* Renal impairment (nephrotic syndrome)
* A history of previous blood clots
* Limb limb fractures or bone pangggul
* The increasing tendency of blood to clot (in certain cancers, use of oral contraceptives, or dehydration)
* Pregnancy and childbirth (especially in cesarean section)
* Smoking (including passive smoking)

SYMPTOMS
Small pulmonary embolism may not cause symptoms, but often leads to shortness of breath. Tightness may be the only symptom, especially when no evidence of infarction.
It is important to note, that the symptoms of pulmonary embolism or vague nature may resemble symptoms of other diseases:
* Cough (occur suddenly, it could be accompanied by bloody sputum)
* Sudden shortness of breath, either at rest or move
* Chest pain that is sharp and gets worse if the patient took a deep breath, coughing, or bending
* Rapid breathing
* Rapid heart rate

Other symptoms that may be found, among others, wheezing, blue skin, decreased blood pressure, pulse weak or absent, dizziness, fainting, and restless.

Diagnosis
Diagnosis is based on symptoms and physical examination there. Various tests that can be done include:
* Chest X-rays. While it can not diagnose pulmonary embolism, but this examination can rule out other disorders that can give similar symptoms.
* Scanning ventilation / perfusion lung
* Pulmonary angiography


TREATMENT
Pulmonary embolism is an emergency, so someone needs to immediately get help at the hospital. It is difficult to determine the prognosis of pulmonary embolism, because many cases are difficult and undiagnosed. In severe pulmonary embolism, where there has been a shock and heart failure, the mortality rate can reach more than 50%.

Handling is done in a hospital might be:
* Keeping the concentration of oxygen in the blood
* Therapy to prevent further clot formation and treatment to break up the clot. The duration of the drug and the dose depends on the circumstances of the patient. At the time given therapy, blood tests may be done periodically to determine whether dose adjustment is necessary or not.

* Surgery, can be performed in cases of severe pulmonary embolism and patients at high risk of recurrence, which is the removal of an embolus from the pulmonary artery.

Various examples of drugs that affect blood clotting:
* Anticoagulant drugs such as Warfarin and Heparin. These drugs can have side effects, such as severe bleeding, blood in the urine, or coughing up blood.
* Thrombolytic drugs, for example tissue plasminogen activator. This type of drug can not be given to people with certain conditions, such as new surgery, pregnant women, or have a tendency to experience severe bleeding.

Due to very serious side effects, the drug is only used by doctors in certain cases with extreme caution. Provision tailored to each patient's condition and with a very strict monitoring.

PREVENTION
For patients who had undergone surgery (especially the elderly), it is advisable to use elastic stockings, move the legs, and immediately began to move actively to reduce the likelihood of clot formation.
In addition, there are several ways you can do to help prevent the formation of blood clots in the legs:
* Avoid sitting for long periods. Stand up and walk every hour, or move (bend) feet as often as possible
* Drink more fluids, but avoid drinking alcohol or caffeine
* If using blood thinners, use as directed by a doctor




News sources :
- Mayo Clinic. Pulmonary Embolism. 2013.
- N, John H. Pulmonary Embolism. Merck Manual Home Health Handbook. 2007.
- W, Benjamin. Pulmonary Embolism. Medicine Net. 2012.
- Web MD. Pulmonary Embolism. 2011.
- NHS. Anticoagulant. 2013
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Pulmonary embolism