The blood coming back from the feet is pressed through the heart to the lungs to oxygenate. This vital to life path can be blocked by a thrombus detached from the deep veins of the leg (or pelvis). Massive pulmonary embolism - also called pulmonary infarction, threatens sudden death!
When pieces of thrombus detached from the deep veins of the leg or pelvis get into the lungs, they can partially or completely block the flow of blood through the lungs. We then deal with a dangerous disease called pulmonary embolism (ZTP). The typical location of the blockage is the lower lobe of the right lung. In extreme cases, a massive embolism can cause necrosis of the lung segment, which is supplied by the artery with a blocked embolism, i.e. a pulmonary infarction.
Where does the embolic material come from?
The embolic material is mostly pieces of thrombus detached from the veins. Sometimes it can cause fat embolism released from tissues into the circulatory system during an injury, bone marrow particles, air, parasites. Almost 90% of the thrombi blocking the flow in the lung arteries comes from the area from which the blood is collected by the inferior vena cava - about 60% from the leg veins, the remaining from the pelvic venous system. In older people, immobilized even for a short time, eg during an airplane flight, thrombosis and detachment of embolic material may occur.
Complications of pulmonary embolism
Embolism causes occlusion of the pulmonary arteries - a sudden increase in resistance to blood flow through the lungs. It causes a threat to health and life in the form of such complications of embolism as: lung and / or pleural pneumonia, lung abscess, right ventricular failure, pulmonary infarction, shock. In the case of a massive blockage, the right ventricle is overloaded with pressure, which can lead to acute right-ventricular failure, while the left ventricle returns too little blood from the lungs to maintain blood pressure and supply blood to the most important organs - it causes shock, loss of consciousness and death. If the compensatory mechanisms in the pulmonary circulation are insufficient, the above-mentioned lung infarction may occur.
In the most severe cases, when the flow of blood through the pulmonary vessels is almost impossible, the patient should be hospitalized as soon as possible in the intensive care unit to eliminate circulatory and respiratory failure. Such a condition not detected and untreated in time threatens sudden death! This is the worst possible end to the disease syndrome called venous thromboembolic disease.
Pulmonary embolism and thromboembolic disease of leg veins
Thromboembolism has two inter-related disease processes - deep vein thrombosis (DVT) and pulmonary embolism (ZTP), which threatens sudden death. Unfortunately, in a civilized world it is quite a common disease. For example, in the US, the inflammation of the deep veins of the lower limbs occurs in about 2 million people, and the pulmonary embolism in about 600,000. In Poland, about 50,000 people suffer from deep vein thrombosis every year, and about 20,000 pulmonary embolism, of which about 30 percent, unfortunately, die. Thrombosis of leg veins
Pulmonary embolism
Pulmonary embolism is the most dangerous consequence of deep vein inflammation complicated by thrombosis.When large thrombus pieces get into the arteries of the lungs, it can lead to shock or sudden cardiac arrest and respiratory arrest followed by death. Patients with pulmonary embolism usually require precise diagnosis and specialized intensive treatment in a hospital setting.
SYMPTOMS OF THE TAPS OF THERAPY
The most common symptoms of pulmonary embolism are:
- suddenly appearing strong dyspnoea (subjective feeling of breathlessness) both during physical and rest,
- chest pain which may radiate under the diaphragm
- quick breathing,
- accelerated cardiac function (tachycardia)
- anxiety
- cough,
- hemoptysis,
- cyanosis, especially on the face
- Pressure drop
- loss of consciousness, fainting
- fever
Beware of symptoms that are not specific - they may be caused by other diseases
Most of these conditions can also be caused by other diseases. For example, chest pain may result from pleural irritation (stabbing, exacerbated by chest movements) or it may be coronary pain occurring in the retrosternal area, sometimes both causes a complication of an embolus. Fever is also a rare and not very characteristic symptom. In contrast, a permanent symptom of pulmonary embolism is the accelerated heart activity - tachycardia, which should be paid special attention, especially when it is unrelated to exercise.
Warning! Pulmonary embolism most often occurs in people:
- after surgery,
- after broken legs, pelvis
- due to severe diseases,
- after the inflammation and thrombosis of the deep veins of the leg
- in pregnant women and after childbirth,
- in women taking oral contraceptives and hormone replacement therapy
- in obese women with massive varicose veins
- with cancer.
ed. Edward Ozga Michalski, MA
drug consultation med. Michał Wojtyczka
Literature:
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2. Treatment of deep vein thrombosis; Professor dr hab. med. Maciej Szczepański - Department of Biochemistry of the Clinical Medical Center for Postgraduate Education in Warsaw; Therapy APRIL 2002
3. Preventive cardiology; editorship of prof. dr hab. med Marek Naruszewicz; Szczecin 2003, publisher of Verso s.c.
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6. How to read and understand the results of medical examinations? bow. med Izabella Barcińska, publ. Literka, 2004
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8. Pulmonary embolism - a challenge for doctors
conversation of Alicja Paciorek-Kolbus with prof. dr. hab. med. Zbigniew Gaciong and doc. dr. n. med. Piotr Pruszczyk from the Chair and Clinic of Internal Diseases and Arterial Hypertension of the Medical University in Warsaw "Żyjmy longer" 11 (November) 2000
