Pulmonary Embolism

Question: What are symptoms of a pulmonary embolism? Hi. A couple of years ago I went to the doctors about a cough I've always had. They did blood work and a chest X-Ray but found nothing. Now recently I found out that my mothers father died of a pulmonary embolism at the age of 33. What I'm wondering is if this cough I have is related to a pulmonary embolism. Also, is a pulmonary embolism genetic?

Answer: The symptoms of pulmonary embolism include (in rough order of prevalence) pleuritic chest pain (pain worst in breathing in), shortness of breath, fever, fast heart rate, cough with/without blood. Large pulmonary emboli can result in low blood pressure and the attendant symptoms - dizziness, blackouts, loss of consciousness, etc. A cough without any other of the above symptoms is quite unlikely to be due to a pulmonary embolus. The tendency to form blood clots (and hence having a higher risk of embolus) can indeed be genetic - there are blood tests to screen for some of the more common conditions, but having a normal test doesn't mean that you are not at increased risk, particularly given your family history. Aspirin is a cheap drug that may be beneficial in lowering your risk of a pulmonary embolus - but I would hasten to add that there is no solid trial evidence for its effectiveness in this context.

Question: Is it possible to get a Pulmonary Embolism while on Warfarin if you've already had one? I sufford from a Pulmonary Embolism while is hospital about 3 months ago. I am now on Warfarin for 6 months but I am wondering is it possible to get another Pulmonary Embolism whilst on it. Every time i get shortness of breath or pain in my leg i panic! Sensible answers only please! Also, after Warfarin, will i be at a greater risk of getting one even if I'm active?

Answer: It is possible, but not likely. When you're on warfarin, you should be having blood tests called a P.T. (Prothrombin Time) and a P.T.T. (Partial Prothrombin Time) which lets your Dr. know if you're blood is anti-coagulated enough. That way the Dr. can adjust your dose when needed. I had a blood clot in my leg that broke off and went into my lungs and my MD had me take these tests weekly for 10 years. I felt the same way you do for many years, but if you have these tests done, that should make you feel less panicked. Also, there is a new injectable medication now called Lovenox, which acts immediately. If you're not having these tests done, you should be.

Question: I recently had a pulmonary embolism, currently on warfrin. What are the risks of getting pregnant? I am concerned about what complications might arrise if I were to get pregnant after my warfrin treatment. Complications for the baby and for myself...Is it ok to have another child after a pulmonary embolism and being on warfrin or are there too many risks invloved?

Answer: I have a genetic blood clotting disorder. The disorder predisposes me to having DVT's. I've had 4. Luckily, they were caught early and didn't end up going into a pulmonary embolism. Each time, I was placed on coumadin (warfrin) for at least 6 months. The first time I got pregnant, I was on the blood thinner. I found out I was pregnant at 6 weeks. I miscarried 2 days later. I lost so much blood, I needed transfusions. My doctor told me Warfrin causes miscarriages in a lot of women. He advised that if I wanted to become pregnant, to stop the Warfrin and start Lovonox injections instead. The injections have to be given in the stomach every day, usually twice a day. They hurt a lot. There is intense burning feeling afterwards for a couple of hours. Most injection sites bruise badly. Having had a blood clot, that makes you high risk, so they will insist on the shots every day for the entire 9 months of pregnancy and after if you want to breastfeed. The downside of Lovenox is that it is very expensive. Over $3000.00 for a month's supply retail. If you have Medicaid, they'll pay for all of it. If you have private insurance with a prescription copay, you'll just have your copay, unless you hit the max for prescriptions in a year. They will probably insist on a planned C-section, because your heart and lungs probably won't deal very well with the strain of labor. They won't let you have an epidural and be awake during it, though. You'll get general because of the risk of bleeding around your spine from the Lovenox, iif they gave you the epidural. Bed rest for the last 6 months of the pregnancy is very probable, too. Been there, done that. I've had 2 children that are both very heathy toddlers, now. They are 17 months apart in age. I had Lovenox shots with them both, bed rest for 6 months with my first, 4 with the second. If you really want another child and are willing to deal with the risks, it is very very worth it. As for getting pregnant on warfrin, highly risky....you'll miscarry 80 percent of the time....birth defects for the other 20. Lots of blood loss for you, could be very serious, if not fatal. Stop the warfrin, go on Lovenox ...then get pregnant, is a better option.

Question: When is it safe to travel after a pulmonary embolism? A friend visiting from Europe developed a pulmonary embolism after a surgery. She has been started on a blood thinner. When is it safe for her to fly back home?

Answer: Never. She needs to become an American citizen and stay here forever. Or at least take a boat home and not a plane. LOL

Question: Is a Pulmonary Embolism the same thing as a heart attack? I'ms tudying for a fnial, and I know a myocardial infarction is the same thing as a heart attack, and the pulmonary embolism is incredibly similar to both in definition. I'm looking for somebody to clarify for me. Thanks guys. that cleared it up. the pulmonary part shoulda given it away.

Answer: A pulmonary embolism is a blood clot in the lung, which will certainly kill you but it's not a heart attack.

Question: How bad is a pulmonary embolism? So my dad has just been admitted to the hospital for a pulmonary embolism, which is a blood clot in his lung. Can anyone tell me how bad these are? He had open heart surgery about a year ago because he had a leaking heart valve. He had a seizure about a year ago but they were never actually sure if it was a seizure or a stroke. He takes blood thinners everyday since his heart surgery. Thanks in advance for your help. My dad already takes cumiden. He has been taking it for a year since his heart surgery.

Answer: Pulmonary embolisms are potentially life threatening - the seriousness is almost pure chance. If a clot is big enough or lasts longs enough to block the blood flow in the pulmonary artery, it usually triggers a severe or fatal heart attack. The blood thinners probably saved your dad's life, or at least kept the embolism from causing any additional problems. An embolism doesn't have any lasting effects - whatever damage it did, if any, occurs within a few minutes. Otherwise, the only lasting danger is the risk of having another embolism in the future.

Question: Why is a Pulmonary Embolism bad for you? I have a blood clot in my aorta veins and the doctors were so concerned that I might have a pulmonary embolism already had a cat scan of my chest and everything was fine I just got off lovenox shots and take coumadin once a day.

Answer: Symptoms and Complications The symptoms of pulmonary embolism can be mild or severe. Some people have many small emboli that can only be detected by special X-ray techniques. A serious blockage, however, can lead to severe breathing difficulty or death. Symptoms of pulmonary embolism appear suddenly and include: shortness of breath, rapid breathing, or wheezing bloody sputum cough lightheadedness, dizziness, fainting sharp chest pain or back pain http://www.medbroadcast.com/channel_condition_info_details.asp?disease_id=50&channel_id=2022&relation_id=16214&rot=4&rating=4

Question: Is chest pain common after pulmonary embolism? I am 32 and was diagnosed with pulmonary embolism in both lungs 2 months ago. The pain in my chest went away for about a month but now is returning and very gradually increasing. The pain is only on the left side. I am not yet having trouble breathing, but if it gets much worse I will. I am somewhat nervous about this since the pain was extreme before. I hope I am not having another episode. Is this a common or something I should be concerned about?

Answer: You should go to the emergency room right away. Don't wait another minute, as this could be very serious; life threatening.

Question: How long after the initial symptoms would a pulmonary embolism cause serious problems? I am doing an essay on 'sudden death' (cheerful, eh?) and am looking for info on pulmonary embolisms / infarction Could anyone tell me how long after initial symptoms (pleuritic chest pain / cough etc) someone wouyld expect to go before hospitalisation is required ? Do PEs come on over time or are they sudden ???

Answer: A Pulmonary Embolism would cause immediate problems. Depending on the type of emboli. How about this: At 2:01 pm a person throws a PE to the lung: 2:02 1. Short of Breath 2. O2 Saturation Drops 3. Unable to get oxygen into the system 4. Hypoxiema 5. Tachycardia 6. Someone had better dial 911 or this person is going to be shaking hands with St. Peter. Time 2:10 7. Cardiac Arrest All right sometimes it is not that dramatic. But on Sunday, I had a patient do just that. Lucky for us he was already on life support and we were able to treat. So sometimes it does go that fast and sometimes it depends on just a lot of other things like: Is the person previously healthy with no lung disease? Then they have a better chance than someone who has extensive lung disease. What is the person's age? Why did they throw the PE? All of these things come into play.

Question: Is there anybody else out there dealing with Protein S, Pulmonary Embolism, How do you deal? I ahve Protein S and Prothrombin gene mutation 20210A is there anybody out there like me? I have had a pulmonary embolism and superficial clotting. I am on coumadin. What do I have to look forward to?

Answer: Below is a good support for you to join that have many other people that have the same clotting disorders that you have. You really aren't alone. Really, if you keep your INR in range you should be fine. Have your family members tested for these though as they are genetic. I have Lupus, APS, Lp(a) and MTHFR.

Question: Pulmonary Embolism? I have pulmonary embolism but I'm having tightness in my chest my doc said it could be a musclar issue but she doesnt know whats causing it. It comes and goes but I do get scared. Could this be apart of P.E.? I do take meds which are blood thinners. Can anyone give me some good advise

Answer: Treatment Prompt treatment of venous thromboembolism — the term used to refer to both pulmonary embolism and deep vein thrombosis — is essential in order to prevent serious complications or death. Initially you'll receive the fast-acting anticoagulant heparin, which helps prevent existing clots from enlarging and stops the formation of new ones. Your doctor is also likely to prescribe the anticoagulant warfarin. It also helps stop clot formation, but because it works less quickly than heparin does, it's used in conjunction with the other drug. After the original clot has dissolved, you'll likely continue to take an anticoagulant medication. How long depends on your particular case. If you have a chronic disorder that puts you at high risk of pulmonary embolism, you may need to stay on these drugs indefinitely. In general, though, you take them for at least six months. As with all medications, the benefits of anticoagulants need to be weighed against the risks. Heparin and warfarin reduce your chance of developing blood clots, but because they also may prevent normal blood coagulation, they increase your risk of bleeding complications. Many of these complications are minor, such as bleeding from your gums, but some may be severe and life-threatening. If you're on warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. During anticoagulant therapy, avoid using aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen, which also affect your blood's ability to clot. Because over 100 other drugs, including over-the-counter medications and some herbs, can interact with anticoagulants, be sure your doctor knows all the medications you're taking. When pulmonary embolism is life-threatening If you experience a massive pulmonary embolism, if you have worsening cardiopulmonary disease, or if other treatments aren't effective, one of the following therapies may be an option: * Clot-dissolving (thrombolytic) therapy. Rather than simply preventing clot formation, medications such as streptokinase, urokinase and the tissue plasminogen activator alteplase actually dissolve clots. They work by activating an enzyme that breaks down blood clots and are sometimes popularly referred to as "clotbusters." You're not a candidate for these drugs if you are pregnant, have had a recent stroke, have severe high blood pressure or have undergone surgery within the past 10 days. Thrombolytic medications increase your risk of bleeding, especially from recent wounds, at needle puncture sites and in your digestive tract, but bleeding can occur anywhere, including your gums when you brush your teeth. Some bleeding may be fatal, especially if bleeding occurs in the brain. * Vein filter. To prevent clots from being carried into the pulmonary artery, a radiologist may surgically place a filter in the main vein (inferior vena cava) in your abdomen leading from your legs and pelvis to the right side of your heart. Prevention CLICK TO ENLARGE Illustration showing support stockings and stocking butler Support stockings Although more than 2 million Americans develop blood clots in their veins every year, many cases of DVT and pulmonary embolism can be prevented with a few simple measures. Some of these measures are used in hospitals. Others are precautions you can take yourself. Preventive steps in the hospital Because DVT often gives few, if any warnings, doctors must take steps to help prevent blood clots in people recovering from a heart attack, stroke or surgery: * Heparin or warfarin therapy. Anticoagulants such as heparin and warfarin are given to people at risk of clots both before and after an operation as well as to people admitted to the hospital with a heart attack, stroke or complications of cancer. * Graduated compression stockings. Compression stockings steadily squeeze your legs, helping your veins and leg muscles move blood more efficiently. They offer a safe, simple and inexpensive way to keep blood from stagnating after general surgery. Compression stockings used in combination with heparin are much more effective than is heparin alone. * Use of pneumatic compression. This treatment uses thigh-high cuffs that automatically inflate every few minutes to massage and compress the veins in your legs. Pneumatic compression can dramatically reduce the risk of blood clots, especially in people who have had hip replacement surgery. * Physical activity. Moving as soon as possible after surgery can help prevent pulmonary embolism and hasten recovery overall. Preventive steps while traveling Sitting during a long flight or automobile ride increases your risk of developing blood clots in the veins of your legs. To help prevent a blood clot from forming: * Take a walk. Move around the airplane cabin once an hour or so. If you're driving, stop every hour and walk around the car a couple of times or do a few deep knee bends. * Exercise while you sit. Flex and rotate your ankles or press your feet against the seat in front of you, or try rising up and down on your toes. And don't sit with your legs crossed for long periods of time. * Wear support stockings. These help promote circulation and fluid movement. What's more, compression stockings no longer look like something your grandmother would wear — they're available in a range of stylish colors and textures. * Drink plenty of fluids before and during the trip. Water is the best liquid for preventing dehydration, which can contribute to the development of blood clots. Avoid alcohol, which contributes to fluid loss. * Talk to your doctor. If you're at high risk of blood clots and plan to fly six hours or more, your doctor may recommend taking low-molecular-weight heparin two to four hours before your departure.

Question: Birth control pills after pulmonary embolism? Have you tried using birth control after a pulmonary embolism? Or any other forms of birth control?

Answer: Do you know what caused the pulmonary embolism? The correct answer may depend on that and your own personal risk factors. But generally, birth control pills are not recommended for someone who is at risk for developing blood clots. The estrogen in birth control can increase clotting factors in your blood, especially if you smoke, are overweight, have a sedentary lifestyle, or have a condition that predisposes you to blood clots. The same would go for any other estrogen-containing birth control. Condoms and diaphragms of course are safe, but not sure about other types of birth control.

Question: Am I high risk for getting another pulmonary embolism after I get my tubes tied? 2 weeks after I had my daughter I landed in the hospital with a pulmonary embolism, drs have since told me I should not have any more kids as I am high risk. I am now wanting to get my tubes tied since I have been taken off the blood thinners. Would I be considered "high risk" following the surgery? I am undecided now on whether to get my tubes tied or not. Any advice is greatly appreciated

Answer: After child birth or any surgery or immobility you are at increased risk of pulmonary emboli. If you are on blood thinners, they would need to be stopped prior to surgery (otherwise you would bleed too much). This increases your risk, as does the actual surgery in which clots can form and subsequently lodge in your lungs. Immobility following surgery can lead to increased formation of deep venous thrombosis (clots) in the legs and hips that can go on to lodge in the lungs also. Once you stop taking the blood thinners (i know some countries give them for life but where I live (UK) its generally 3-6 months) go to a doctor and discuss your options. I'm sure that whilst you take warfarin you are not allowed to have an elective surgery - emergency surgery is a different case - anyway going off topic. I would recommend talking to your family doctor for more information; hope this gives you a rough guide. As someone asid above oral contraception is not an option as it increases the formation of clots (makes your blood sticky).

Question: can you get a pulmonary embolism 2 times? I am 35 years old and last year I had a pulmonary embolism. I did not have surgery prior to. the drs. still don't know what caused it. Before it happened I do remember my legs feeling tired and charlie horse like feelings. maybe a dvt. but isn't that odd for a 35 year old?

Answer: Yes. The symtoms you feel on you legs are probably called claudication. Yes, DVT is a possibility but what is causing your DVT's if you have it. Is there something causing you blood to be more viscous than normal like an autoimmune disease. Do you have varicose veins on your legs. Might want to get a vascular ultrasound of blood vessels of your legs. IF it is DVT, some preventive measures are taking of medication that will make you blood less viscous (pls. ask your doctor), wearing support or anti-DVT stockings and maybe considering having an inferior vena cava (IVC) filter placed to prevent blood clots from going into you lungs again.

Question: I have a pulmonary embolism and i just found out today that i am pregnant? i am horrified im so scared i don't know what to do with myself. i keep hearing these stories about infant mortality and death after childbirth. im scared shitless! is there anything anyone can tell me about having a pulmonary embolism and being pregnant? 1st trimester

Answer: I had a pulmonary embolism in my 8th week of pregnancy back in May. I was very scared. I was transferred to a wonderful high risk OB doctor who put me on 100 mg of Lovenox 2x daily. Contact your OB Dr. RIGHT AWAY and let them know what is going on. Lovenox is an injection safe for the baby. If you are on Coumadin, that can be very dangerous to the baby. After the birth of my first daughter last June, I had a DVT in my leg. I was on coumadin for 6 months. My first month off of it I got pregnant (this past March). WHen I had the Pulmonary Embolism, they were not sure where the clot came from. My legs were free from clots.They gave me a CT scan and that determined the clot in my lung. The OB Dr. did blood work to find out if there was a reason for my blood clots, and I have a blood clotting disorder called MTHFR. You will probably be sent to see a hematologist for testing also. With the exception of the PE, I had a normal pregnancy, no other problems. The Dr. believes that the clots are a result of me being pregnant, the MTHFR, and my size. Now that I am delivered I am taking 10mg of Coumadin for the next 6 months. I was on the Lovenox for my entire pregnancy. When I was 35 weeks i had an amniocentesis to see if the baby was developed enough to be delivered. I had low fluid levels, so I was C-sectioned (I was a previous c-section). My baby is 7 weeks old, healthy and beautiful. The high risk OB Dr. monitored me closely. They took good care of me and they will take good care of you too. Please call your OB asap, so you can be put on the right medications, if you are not already. Good luck to you, and you can feel free to ask me any questions.

Question: Pulmonary Embolism: What are the chances of a good outcome? I've been a rather pessimistic person all my life, but for the past few years I have been the total opposite, and have been very optimistic. This morning, I went to the doctors office with my grandmother where they said she would be fine, they caught whatever illness early. Then within 3 hours, I receive a call - she's in the ER and this minor illness turned out to be a blood clot in her lung. Later, we receive another call that made it sound like things weren't getting any better. I am relying that those taking care of her will do all they can manage to do, I trust their skill and education with my grandmother - but I do not want to ignore the likelihood of the situation - what are the chances of a good outcome of Pulmonary Embolism? I've already been doing research since we learned what the issue was, and learned that it is the third greatest killer of hospitalized patients, which did not make me feel any better, but I have accepted it. Thank you for any help and information you can provide me.

Answer: Hello there, I am sorry to hear about your grandma. This can be a very life threatening illness, but if caught in time, then should be treated, they will need to give her injections and treatments for a few months to thin the blood hence breaking down the blood clot. I know how your Grandma feels right now, I have been in hospital with suspected PE before. If it helps, I work in the hospital and have heard of a fair few patients who have suffered with a PE before, yet survived, some of these patients have even had a PE twice! Good luck make sure you visit her as much as you can. That was all I wanted when I was in hospital. My family to make me feel safer.