A pulmonary embolism is a partial or total blockage of an artery in the lungs by a blood clot. The risk factors are multiple and the symptoms are most often sudden. About 10,000 people suffer an embolism each year. A pulmonary embolism occurs when a blood clot blocks a pulmonary artery or one of its branches. Usually the clot forms because of phlebitis (most often in a leg, sometimes in an arm), then it breaks off and travels through the venous circulation to the heart.
With each contraction, the heart propels the clot towards the pulmonary arteries, where it eventually becomes blocked. When the clot is small, it causes damage to the lungs. But if it is more important, it can prevent the blood from circulating in the lungs and cause death.
What are the symptoms that should alert?
- One shortness of breath sudden difficulty in breathing
- A sharp chest pain that gets worse when you try to take a deep breath
- Slightly pinkish sputum that you expectorate while coughing
- An accelerated heart rate
Who is at risk of embolism?
The French Federation of Cardiology estimates the frequency of pulmonary embolism at 100,000 cases per year in France, including 10,000 to 20,000 fatalities.
- All people who have to stay in bed are at risk because the lying position slows blood circulation, making it conducive to the formation of clots.
- Certain conditions such as heart failure, infectious diseases, or cancer can cause phlebitis, thus putting you at risk of embolism.
- Patients who have undergone a surgical intervention and especially an orthopedic, gyneco-obstetrical intervention or against the Cancer.
- Women on oral contraception, and especially young women on 3rd or 4th generation pill.
- Smokers.
- The elderly (over 70) and overweight.
How is the diagnosis made?
In the event of symptoms evoking a pulmonary embolism (and especially if there are already risk factors), call the Emergency Department immediately (15 or 112). And while waiting for help, place the person in a seated position, preventing them from moving to avoid migration of the clot.
At the hospital, additional tests will confirm the diagnosis:
- A blood test.
- A echocardiography which makes it possible to assess the severity of the pulmonary embolism by checking its impact on the right heart chambers (when the right ventricle malfunctions, there is a significant risk of death).
- A lung scan to visualize blood clots in the lungs.
- One venous echo-doppler of the lower limbs is systematically carried out, in search of a phlebitis.
How to treat a pulmonary embolism?
Doctors treat pulmonary embolism with medicines called blood thinners that prevent new clots from forming and prevent existing clots from growing. The treatment is first administered by subcutaneous injections. But after a few days, the bites are replaced by oral anticoagulants.
Among them are vitamin K antagonists (AVK) which are the reference drugs and, since 2012, direct oral anticoagulants (OAD): Dabigatran and Rivaroxaban.
Some patients will take this treatment for a few months. Others, considered at risk patients, may need it for the rest of their lives.
Sources:French Federation of Cardiology and Ameli health
Read also :
- Fewer pulmonary embolisms in women
- Phlebitis: 2 out of 3 French people do not know the signs
- Michel Polnareff, 72, hospitalized for a pulmonary embolism
- Varicose veins can herald future thrombosis
