Pulmonary Embolism

A pulmonary embolism is a blood clot that starts in the extremities and travels to the lungs through the pulmonary arteries where it gets trapped.  If the embolism is large enough it can restrict the function of the lungs and can be very dangerous.

How do we diagnose a Pulmonary Embolism?

Computed Tomography Angiography (CTA)

CTA the most rapid and accurate test to detect a PE.  This is the most common test to detect a PE.

Ventilation and Perfusion (V/Q) scan

A V/Q scan uses an injection to see the blood flow to the lungs and an inhaled tracer to see the airflow in the lungs.  When there is less blood flow to a segment of the lung this can indicate a PE.

How do we treat a Pulmonary Embolism?

Most pulmonary embolic disease is treated simply with blood-thinning medications.  However, if an embolism is detected one of the first things done is to look in the extremities to see if there is more clot.  If there is more clot if it breaks free the embolism can get larger and more dangerous.

Venous Ultrasound:
The veins in the legs and sometimes the arms are examined with venous ultrasound to detect any blood clots which may break free and travel to the lungs.

Inferior Vena Cava (IVC) Filter:
If there is enough clot left in the legs an IVC filter can be placed in the main vein in the belly, the IVC.  This filter can catch the clot traveling upwards from the legs before it gets to the lungs.

Pulmonary Thrombolysis:
If the clot is very large and immediately life-threatening further treatment may be needed where a catheter is fed through the veins in the groin up to the clot in the chest.  From there clot-busting medication can be given which will dissolve the clot (thrombolysis) or the clot may be removed directly.