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Pulmonary embolism (PE) is so common and lethal that a diagnosis should be sought actively in every patient who presents any chest symptoms so it can be proven there is no other cause:• Symptoms include chest pain, chest wall tenderness, back pain, shoulder pain, upper abdominal pain, syncope, hemoptysis, shortness of breath, painful respiration, new onset of wheezing, any new cardiac arrhythmia, or any other unexplained symptom referable to the thorax.
• Classic signs and symptoms of PE (hemoptysis, dyspnea, chest pain) are not sensitive or specific. They occur in fewer than 20 percent of patients in whom the diagnosis of PE is made, and most patients with those symptoms are found to have some etiology other than pulmonary embolism to account for them. Of patients who die from PE, only 60 percent had dyspnea, 17 percent had chest pain, and 3 percent had hemoptysis. Nevertheless, the presence of these symptoms is an indication for a complete diagnostic evaluation.
• Patients with PE often present primary or isolated complaints of seizure, syncope, abdominal pain, high fever, productive cough, new onset of reactive airway disease ("adult-onset asthma"), or hiccoughs. Some may present with new-onset atrial fibrillation, disseminated intravascular coagulation, or one of many other signs or symptoms.
• Pleuritic or respirophasic chest pain is a particularly troublesome symptom in relation to PE. PE has been diagnosed in 21 percent of young, active patients who seek treatment for pleuritic chest pain. These young patients usually lack any other classic signs, symptoms, or known risk factors for pulmonary thromboembolism, and such patients often are dismissed inappropriately.
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How PE Attacks
In order to reach the lungs, a blood clot (thrombus) travels up the veins to the inferior vena cava. The clot then travels up to the right atrium of the heart and passes through the right ventricle into the main artery of the lung, called the main pulmonary artery. The clot then gets lodged in the main pulmonary artery, or a branch of the pulmonary artery, where it obstructs blood blood flow.
When a pulmonary artery is blocked by an embolus, sufficient oxygen is not pumped into the blood. A large emboli may cause so much blockage that the heart strains to pump blood through the arteries that do remain open. If too little blood is pumped, or the heart is strained excessively, a person can go into shock and ultimately die.
How to Diagnose Pulmonary Embolism
There are a number of tests that can detect PE. Which tests are best is dependent on your condition when you arrive at the hospital or emergency room, your risk factors for PE, available testing options and other conditions you may have. However, the following tests are available for PE detection:
• Ultrasounds - Doctors use ultrasounds to look for blood clots in patients’ legs.
• Computed Tomography (CT) Scans - Doctors use CT scans to look for blood in patients’ legs and lungs.
• Lung Ventilation/Perfusion Scan - A lung ventilation/perfusion scan, or VQ, uses a radioactive substance to show how well oxygen and blood are flowing to all areas of the lungs.
• Pulmonary Angiography – A pulmonary angiography is a test not available at all hospitals and requires a trained specialist. For this test, a flexible tube, called a catheter, is threaded through the groin and dye is injected into the blood vessels through the catheter. X-ray pictures are then taken to show if blood is flowing through the blood vessels and into the lungs.
• Blood Tests – There are a number of blood tests available that may help your doctor find PE, such as a D-dimer, which measures a substance in the blood that's released when a clot breaks up.
Pulmonary embolism (PE) is treated primarily with medicines, procedures, and other therapies. The two main goals of treating PE are to stop the blood clot from getting bigger and keep new clots from forming. Treatment may also include medicines to thin the blood, slowing its ability to clot. If your symptoms are life-threatening, your doctor may give you medicine to dissolve the clot more rapidly. On very rare occasions, a doctor may use surgery to remove a clot.
Contact the Experienced Medical Malpractice Attorneys Pittsburgh, PA at Berger & Lagnese, LLC for a Free Consultation
Even the most pristine facilities in all of Pittsburgh can make mistakes in treatment, including UPMC Children's Hospital of Pittsburgh, UPMC Mercy, and St. Clair Hospital. Berger & Lagnese, LLC represents people who have been injured, or the families of those who have died, by missing PE diagnosis, misdiagnosis, or mistreating PE symptoms. Our attorneys specialize in medical malpractice cases in Pennsylvania, including Pittsburgh, Greensburg, Beaver, Uniontown, Erie, and Washington PA. Our office is located at 310 Grant St #720, Pittsburgh, PA 15219 and consultations can be scheduled either online here or over the phone at (412) 471-4300.