Pulmonary embolism

• www.mayoclinic.org
• Shortness of breath. This symptom typically appears suddenly and always gets worse with exertion.
• Chest pain. You may feel like you're having a heart attack. The pain is often sharp and felt when you breathe in deeply, often stopping you from being able to take a deep breath. It can also be felt when you cough, bend or stoop.
• Cough. The cough may produce bloody or blood-streaked sputum

Other signs and symptoms that can occur with pulmonary embolism include:

• Rapid or irregular heartbeat
• Lightheadedness or dizziness
• Excessive sweating
• Fever
• Leg pain or swelling, or both, usually in the calf caused by a deep vein thrombosis
• Clammy or discolored skin (cyanosis)

Complications

Pulmonary embolism can also lead to pulmonary hypertension, a condition in which the blood pressure in your lungs and in the right side of the heart is too high. When you have obstructions in the arteries inside your lungs, your heart must work harder to push blood through those vessels, which increases blood pressure and eventually weakens your heart.

Prevention

Preventing clots in the deep veins in your legs (deep vein thrombosis) will help prevent pulmonary embolism. For this reason, most hospitals are aggressive about taking measures to prevent blood clots, including:

Blood thinners (anticoagulants). These medications are often given to people at risk of clots before and after an operation — as well as to people admitted to the hospital with medical conditions, such as heart attack, stroke or complications of cancer.

Compression stockings. Compression stockings steadily squeeze your legs, helping your veins and leg muscles move blood more efficiently. They offer a safe, simple and inexpensive way to keep blood from stagnating during and after general surgery.

Leg elevation. Elevating your legs when possible and during the night also can be very effective. Raise the bottom of your bed 4 to 6 inches (10 to 15 cm) with blocks or books.

Physical activity. Moving as soon as possible after surgery can help prevent pulmonary embolism and hasten recovery overall. This is one of the main reasons your nurse may push you to get up, even on your day of surgery, and walk despite pain at the site of your surgical incision.

Pneumatic compression. This treatment uses thigh-high or calf-high cuffs that automatically inflate with air and deflate every few minutes to massage and squeeze the veins in your legs and improve blood flow.

Prevention while traveling

The risk of blood clots developing while traveling is low, but increases as long-haul travel increases. If you have risk factors for blood clots and you're concerned about travel, talk with your doctor.

• Drink plenty of fluids. Water is the best liquid for preventing dehydration, which can contribute to the development of blood clots. Avoid alcohol, which contributes to fluid loss.
• Take a break from sitting. Move around the airplane cabin once an hour or so. If you're driving, stop every so often and walk around the car a couple of times. Do a few deep knee bends.
• Fidget in your seat. Flex your ankles every 15 to 30 minutes.
• Wear support stockings. Your doctor may recommend these to help promote circulation and fluid movement in your legs. Compression stockings are available in a range of stylish colors and textures. There are even devices, called stocking butlers, to help you put on the stockings.

++++++++++++++

Heart Disease and Clot Buster Drugs

It’s important to know the signs and symptoms of stroke and heart attack. Call for emergency help (911 in most areas) right away if you or someone you know is having them. The faster treatment is given, the quicker blood flow will be restored to the area and the greater the chance to prevent long-term damage, or even death.

There are several drugs to break up clots, including:

• Tissue plasminogen activator (tPA)
• Tenecteplase
• Alteplase
• Urokinase
• Reteplase
• Streptokinase

Some people aren't able to take clot busters. Please tell your doctor if you have any of the following conditions:

• Previous hemorrhagic stroke or bleeding in the brain
• Known cerebral vascular lesion or tumor
• Previous allergic reaction to a clot buster, or other allergies
• Active bleeding (excluding your menstrual period)
• Pregnancy
• Uncontrolled high blood pressure
• Bleeding disorder, or recent history of bleeding in any part of the body
• Severe liver disease
• Recent surgery (less than 2 weeks ago)
• Trauma, falls, or blows to the head within the past 3 months
• Recent CPR
• Active peptic ulcer

 side effects with clot busters. Notify your doctor if you notice:

• Bleeding or oozing from cuts or around where you got your shot
• Allergic reaction
• Fever
• Low blood pressure
• Signs of bleeding from other sites within the body, such as blood in the urine, black tarry stools, nosebleeds, and bleeding from the gums

• Any other unusual symptoms