Pulmonary Embolism: A Case Study

I enjoyed reading your informative post. There are several risk factors that predispose anyone to develop DVT/PE such as age, obesity, infection, immobilization, hormone therapy, tobacco use, pregnancy, air travel, hospitalization and surgery in particular. As you well articulated in your post , the 44-year-old African American male patient had surgical procedure which is obviously one of the risk factor to developing DVT/ PE and having a cancer tumor makes the tendency of blood clot even worse. The other important risk factor that you haven't mentioned in your post is that for reasons that are not unknown, DVT/ PE disproportionately affect African American "African American men and women have a 30% higher chance

Acute chest syndrome has been studied extensively in the past due to two reasons. First, it is the leading cause of death in patients with sickle cell disease. Secondly, there is not optimal treatment for acute chest syndrome. This is because there are so many factors that can cause it. Pulmonary fat embolism can cause acute chest syndrome, but so can viral infections, bacterial infections, and mixed infections (Vichinsky, 2000). While there are so many causes of acute chest syndrome, the most noticeable was pulmonary fat embolism, which account for 8.8% of all acute chest syndrome occurrences (Vichinsky, 2000). On table 4, you can see each disease that caused the onset of acute chest syndrome, and how many people it affected.

The pulmonary vasculature contains arteries and arterioles, which branch in the lungs to create a dense capillary bed to provide blood flow. The pulmonary capillary bed is a high-volume, low-pressure, low-resistance system that delivers blood to and from the lungs via the arterial and venous circulation systems. The right ventricle of the heart is responsible for pumping blood to the pulmonary artery and to the lungs so it can be oxygenated while the left ventricle pumps oxygenated blood to the tissues. Typically, hypertension refers to high blood pressure in the systemic circulation, however, an increase in blood pressure may also occur in pulmonary circulation. The pulmonary artery supplying blood to the lungs can become narrowed,

Fat embolism is a process that fat tissue passes into the bloodstream that travels through the bloodstream and lodges and blocks a blood vessel. This typically occurs between 12 to 36 hours after an injury. A fat embolism almost always occurs with major trauma or an elective surgery that requires intramedullary nailing of long bones. Although a fat embolism is rare it leads to occlusion

Thrombi generally form in the deep veins of the calf and after that propagate into the proximal veins, including and above the popliteal veins, from which they will properly embolize. Around 79% of patients who present with pulmonary embolism have

The pulmonary edema is a result of the heart not being able to pump correctly, leading to blood being backed up in the veins that take blood through the lungs. (Chen, 2015) Later the fluid is pushed in the air spaces, and the fluid reduces the normal amount of oxygen movement through the lungs. This is what causes the shortness of breath. The congestive heart failure that leads to pulmonary edema may be a result of the high blood pressure as well. (Chen, 2015) Environmental factors and infections may contribute to worsening the

Pulmonary hypertension in this case likely resulted as a product of the initial pulmonary fibrosis. As the lungs stop working, the pulmonary blood pressure rises, which creates additional work for the right

Most often the increased pressure is the result of blood backing up from a failing left ventricle, but right ventricle failure can also be a result of chronic pulmonary disease and pulmonary hypertension. The right ventricle’s inability to pump blood forward into the lungs results in peripheral congestion and an inability to accommodate all the venous blood that is normally returned to the right side of the heart. Venous blood is returned backward into the systemic circulation. Increased venous volume and pressure force fluid out of the vasculature into interstitial tissue which causes peripheral edema. Edema appears in depended areas of the body such as the sacrum when supine and the feet and ankles while in an upright position. As right ventricle failure continues, edema may progress to pitting edema and moving up to the legs into the thighs, external genitalia, and lower

After coming out of the bone marrow, the red blood cell makes its way into the bloodstream, taking up most of the space along with plasma. This blood makes travels through the vein capillaries, and eventually the arteries. This now deoxygenated blood is ready to be filtered by the heart.

If an aggressive treatment is needed, it may require thrombolytic medicines, which help to dissolve the blood clot rapidly. There are benefits from taking thrombolytic medicine but on the down side it can increase the risk of severe bleeding. Another form of treatment is to have an embolectomy performed through surgery or minimally invasive procedure. "Having a vena cava filter inserted into the large central vein of the body" (WebMD, 2014) has also resulted in being very beneficial to patients. The filter helps prevent blood clots from reaching the lungs and normally used as a resource for patients who cannot take any

In addition to prompt treatment, we can all take measures to prevent blood clots in our legs, first of all, by determining whether we have any family history of clotting issues. If we sit a lot, we should move around every hour or so, particularly if we are traveling. If moving around is restricted, we can rotate our ankles or try pressing our feet against something or by rising up and down on our toes. We should not sit with our legs crossed for extended periods of time. In addition to movement, we should stay hydrated. Water is the best liquid for preventing dehydration which can contribute to the development of blood clots. Avoiding alcohol is a good idea. If you have a personal or family history of blood clots, wearing compression stockings is also recommended as they help to promote

For this condition to occur, many things have to take place in the body. First the pulmonary capillaries and alveoli epithelial tissues become inflamed. This results in absorbency of these layers of tissues which then leads to plasma, which is abundant in protein, to escape out of the capillaries and into the alveolar space. After the trauma to the alveolar lining occurs, this allows fluid into the alveoli, which then results in pulmonary edema. During this whole process damage to two different types of cells is being done. Type I and II of the alveolar epithelial cells. Type II

Small embolism that stuck in the peripheral branches of the pulmonary artery are clinically silent and may go unrecognized. People with moderate-sized emboli often present with breathlessness accompanied by pleuritic pain, apprehension, slight fever, and cough productive of blood-streaked sputum. Patients with massive emboli frequently specific with sudden collapse, crushing substernal chest pain, shock, sometimes loss of consciousness; so massive emboli often are mortal (Porth, 2011).

Venous thrombosis is when a blood clot forms in a vein. Deep vein thrombosis (DVT) occurs in a vein far below the surface of the skin. DTV typically appears in the legs or pelvis. Symptoms of DVT include pain or swelling in the leg, red skin and abnormally large veins. An untreated blood clot is a serious condition that can result in a pulmonary embolism (PE). This is when the blood clot becomes stuck in a lung. This life threatening condition can cause breathing difficulty, chest pain and ultimately physical collapse.

This article discusses how diagnosing pulmonary embolism (PE) is still a challenge. The reason is that there are different imaging modalities. The writers purpose in this article is to determine the accuracy of the ultrasound (US) machines in suspected PE situation. The study includes 50 patients, who are suspected to have PE, and all patients went through clinical and imaging examinations. Later on, a chest physician and radiologist were asked to perform a thoracic US to identify if those patients have PE or not. The results of the clinical investigations show that 30 patients have PE, while the results of thoracic US indicate 27 positive cases. In conclusion, the study demonstrates that the accuracy of detecting PE using thoracic US is between