A pulmonary embolism often occurs suddenly and leads to severe symptoms and even cardiac arrest. That does not have to be that way. The disease often goes unnoticed, explains a lung expert. She should be treated as soon as possible.
Berlin – A pulmonary embolism is a serious, often life-threatening disease that can appear out of nowhere and have serious health consequences. But in many cases it also occurs without the symptoms immediately suggesting a dangerous emergency.
It often goes unnoticed because the diagnosis is not always easy. In Deutschland an estimated 30,000 to 100,000 people die each year from a pulmonary embolism, reported kreiszeitung.de. It is all the more important to know the signs in order to be able to act quickly in an emergency.
Diagnosing a pulmonary embolism is often difficult because the symptoms are non-specific
A pulmonary embolism is always caused by a blood clot causing the pulmonary vessels to become blocked. So it’s basically not one lung disease as such, but in principle it is only at this point that what arises elsewhere in the body becomes acute. The cause of the disease is not in the lungs, but elsewhere.
“In the case of a pulmonary embolism, a thrombosis develops somewhere in the body, for example in the leg veins. This blood clot is carried to the heart by the venous blood. From there it gets into the fine pulmonary arteries and gets stuck there like in a sieve. The pulmonary vessel closes and the typical symptoms occur,” explains Gunther Wiest, chief physician of the clinic for pneumology at the Asklepios Klinikum Hamburg, in an interview with the district newspaper von IPPEN MEDIA.
Pulmonary embolism: what signs indicate the disease
The symptoms that patients experience with a pulmonary embolism are often very non-specific, says Wiest. Differentiating it from other diseases with similar symptoms is often not easy. “But if you think straight away, from a medical point of view, that the patient presented could have a pulmonary embolism, then the diagnosis is very easy and, if there is a well-founded suspicion, it happens very quickly. As the doctor treating you, you just have to come up with it.”
However, this is made more difficult by the fact that diseases such as Heart attack, lung cancerpneumonia, tuberculosis, stomach ulcers or even pinched nerves, according to experts, can often cause similar symptoms.
The size of the blood clot determines the severity of the symptoms of a pulmonary embolism
How easy or difficult it is to recognize the disease depends, according to the German Lung Foundation also on the size of the clot and the resulting vascular occlusion. In the case of small pulmonary embolisms, there are often only a few symptoms. Large clots, on the other hand, can lead to acute cardiac arrest and death.
However, this is rarely the case when someone collapses dead on the street
In most cases, the root cause, i.e. the thrombosis, develops slowly and there are harbingers that point to it. In this case, you have to be particularly vigilant, because a piece of such a clot could tear off and be washed further through the body with the blood flow.
“The lungs are the first constriction in the body where such a clot can get stuck”
The lung is, so to speak, only “the first constriction, the first sieve” in which such an embolus can get stuck, explains Wiest in an interview with the district newspaper. “Even if it did get through there, it would go from there into the left side of the heart and be pumped into the systemic circulation. In the worst case, it then causes blockages in the brain, i.e. one stroke. Or will lead to the death of the Intestinal tissuesif a vessel is affected there.”
Therefore, the first measures in the treatment of a pulmonary embolism are aimed at preventing further rupture of such clots. This is to prevent the central vascular system from becoming completely clogged, because then there is a risk of cardiac arrest. However, the lung tissue does not die off as quickly as, for example, the brain tissue in a person stroke because the lungs are supplied with blood and oxygen via a second system. As a result, the failure of the closed vessel can usually be well compensated for at first.
The symptoms of a pulmonary embolism are often similar to those of other diseases
According to the German Lung Foundation, the most common symptoms of a pulmonary embolism include:
- shortness of breath
- chest pain
- Cough, often bloody sputum
- Fever
- Signs of thrombosis: swollen leg or other part of the body that is very painful
Some embolisms cause very severe symptoms, while others cause no symptoms at all. The entire spectrum is possible. “Sometimes we only discover that a patient has a vascular occlusion in the lungs because we are doing a computed tomography for a completely different reason, for example because of a known one Bronchialkarzinoms. In this case, we only see afterwards that there is a pulmonary embolism, the course was then completely asymptomatic,” Wiest describes to the district newspaper the difficulty in recognizing the disease.
First aid for pulmonary embolism: “As a layperson, you can basically do nothing, but you can’t make anything worse either”
Specific tests that laypeople can also carry out and as there are for stroke, do not exist. “As a layman you can’t basically do anything, but you can’t make anything worse either. Because the only thing that helps is blood thinning. And passers-by on the street can’t do that.”
People with the typical symptoms would therefore have to go to the doctor or the emergency room quickly. In the event of an acute cardiac arrest, attempts should be made to resuscitate the patient as much as possible. This can be learned in first aid courses.
Suspected pulmonary embolism: how can outsiders recognize the emergency and what can they do?
If there is a clear suspicion of a pulmonary embolism, detailed diagnostic measures are initiated immediately. The pulmonary embolism can only be made visible with a computer tomographic angiography, a so-called angio-CT. In a normal family doctor’s practice, the necessary equipment is of course not available. Doctors in private practice will therefore initially resort to the D-dimer test, which measures the breakdown products of blood clots in the body. If it is positive, this is an indication that thrombus material is being broken down in the body, i.e. a clot is present or has been present.
The test can also work in other diseases, such as pneumonia or tumor diseases. The ultrasound device can be used to detect indirect signs of a pulmonary embolism in the heart – primarily increased heart pressure or weaker pumping capacity of the right side of the heart. This is usually followed by a referral to the hospital, where the clot is then removed with drugs such as heparin.
Can you fully recover after a pulmonary embolism? What consequences are possible
As subsequent therapy, an attempt is made to keep the risk of new thrombosis as low as possible. Because they could lead to further vascular occlusions. To do this, those affected often have to take blood-thinning tablets permanently. Bedridden people, people who have just had an operation and travelers who sit motionless in a seat on an airplane or bus for a long time have a particularly high susceptibility to developing thrombosis. You should always get up and walk a few steps or wear thrombosis stockings as a preventive measure. Pulmonary embolisms often put a lot of strain on the heart and can therefore cardiac arrhythmias or result in heart failure.
For high-risk patients who have a coagulation disorder or a particularly pronounced weakness in the deep veins of the legs, it is also worth taking a preventive dose of heparin as an injection before flying. The general risk of thrombosis also increases Smokingobesity, taking hormones – for example for contraception –, vascular calcification, Diabetes or a weakness in the deep veins of the legs. Alcohol doesn’t play such a big role in this context, says Wiest. Smoking is a much bigger problem for him as a lung specialist. Basically, a moderate lifestyle is recommended for good health.
