Pulmonary embolism - a pathological process, which is characterized by blockage of the pulmonary artery by a thrombus (embolus), formed in the right ventricle or atrium, as well as in the systemic circulation.
Blood clots in small sizes only harm the lungs themselves, but to serious consequences will not result, and has large emboli while blockage of the pulmonary artery will lead to death.Currently, statistics show that the majority of patients suffering from cardiovascular disease, dying of pulmonary embolism (PE).It may also happen instant death, and in the postoperative period.
Diagnosis of this disease process is very complex and sometimes erroneous, and therefore people often die within the first two hours after the onset of the initial symptoms.
What causes pulmonary embolism?
An important reason for the prevalence of blood clots is the process of thrombus formation on the process of fibrinolysis.Consequently, thrombus synthesized on vessel walls, and to increase in size detached from the
disease contributes to thrombosis:
- thrombophlebitis of the lower extremities;
- patients who assigned bed rest, so they need to take for prevention fibrinolytics as well as to family members did on their feet gymnastics;
- CHD: myocardial infarction;
- rheumatic fever, infective endocarditis, cardiomyopathy;
- atherosclerosis, obesity II degree;
- use of oral contraceptives and other
Three major factors that must be performed for pathological thrombus formation:. Damage to the vascular wall, slowing blood flow and increase the coagulation system.
characteristic clinical picture depends on:
- volume of lung blood vessels;
- speed development of pulmonary thromboembolism;
- disorders arising due to blockage of the pulmonary artery;
- the patient's condition.
PE may occur as asymptomatic, and with the outcome of sudden death.The very nonspecific clinical picture, and it can be differentiated only by the sharp and a sharp top with no visible other diseases (myocardial infarction, pneumonia, etc.).
Depending on the symptoms allocate appropriate syndromes:
- acute vascular insufficiency - fall in blood pressure up to the development of collapse and shock.Logged tachycardia.
- acute coronary insufficiency - stabbing chest pain that may radiate to the left arm and shoulder blade, lasting from a few minutes to several hours.The ECG is recorded beats, atrial fibrillation.
- acute pulmonary heart - pulmonary artery pressure increased, and as a result, the liquid begins to propotevat in lung tissue, which is why it is developing edema.Lung tissue is compressed, and the right ventricle is unable to cope with the load.Clinic of the syndrome: tachycardia, epigastric pulsation, swelling of the neck veins.
- acute cerebrovascular insufficiency - developing cerebral hypoxia due arising collapse and the formation of several blood clots, which can get into the brachycephalic artery and further along the carotid arteries in the brain - is developing a brain edema.Symptoms: dizziness, tinnitus, fainting, coma, convulsions.
- pulmonary pleural:
- acute respiratory failure - shortness of breath, the black hole of up to 40 per minute, diffuse cyanosis.
- moderate bronchospastic syndrome - are heard on auscultation wheezing.
- pulmonary infarction - develops on 1 -3 day.Complaints: shortness of breath, cough with blood, chest pain.
- inflammation in the lungs.
- swelling of the hepatic veins.Complaints of pain in the right upper quadrant.
Treatment of pulmonary embolism
Perform resuscitation, which includes removing the patient from a state that threatens his life.Subsequently, the circulation is reduced as a whole, normalize the pulmonary circulation.Be prevented by preventing the development of chronic pulmonary hypertension.If necessary, prescribe oxygen therapy and fibrinolytic drugs.When inflammation - antibiotic therapy.
Emergency care pulmonary embolism may be used depending on the clinical manifestations, prevented developed symptoms on the spot improvised medical facilities, as well as the need to hospitalize the patient.