Thromboembolism of the pulmonary artery: symptoms and treatment of the disease

Thromboembolism of the pulmonary artery is a pathological process that is characterized by blockage of the pulmonary artery by a thrombus( embolus) formed in the right ventricle or atrium, as well as in a large circle of blood circulation.

Thrombi of small sizes will only harm the lungs themselves, but they will not lead to serious consequences, and already large emboli with a blockage of the pulmonary artery will lead to death. Currently, statistics show that most patients suffering from cardiovascular diseases die from pulmonary embolism( PE).Also, instant death can occur in the postoperative period.

Diagnosis of this pathological process is very complex and erroneous, and therefore people often die within the first two hours after the onset of initial symptoms.

What are the causes of thromboembolism of the pulmonary artery?

An important reason for the formation of thrombi is the prevalence of thrombogenesis over fibrinolysis processes. As a result, thrombi are synthesized on the walls of the vessels, and on an increase in size they detach from them, and, reaching a vessel smaller in diameter, clog it, causing ischemia of the corresponding organ.

Thrombogenesis-promoting diseases:

• thrombophlebitis of the veins of the lower limbs;
• patients who are assigned to bed rest, so they need to take fibrinolytics for prophylaxis, and also for relatives to do gymnastics on their legs;
• IHD: myocardial infarction;
• rheumatism, infective endocarditis, cardiomyopathy;
• arterial hypertension;
• arteriosclerosis of vessels, obesity of the II degree;
• use of oral contraceptives, etc.

The three main factors that must be fulfilled for the pathological formation of a blood clot: damage to the vascular wall, slowing blood flow and increasing the coagulation system.

Symptoms of the disease

Characteristics of the clinical picture depends:

• volume of the affected pulmonary vessels;
• rate of development of thromboembolism of pulmonary arteries;
• arising disorders due to blockage of the pulmonary arteries;
• the patient's condition.

PE can be as asymptomatic as it is with the outcome of sudden death. The clinical picture itself is nonspecific, and it can only be differentiated by a sharp and acute onset without visible other diseases( myocardial infarction, pneumonia, etc.).

Depending on the symptoms, the corresponding syndromes are isolated:

1. Cardiovascular:
   • acute vascular insufficiency - blood pressure drops up to the development of collapse and shock. Tachycardia is recorded.
   • acute coronary insufficiency - dagger pain behind the sternum, which can irradiate into the left arm and shoulder blade, lasting from several minutes to several hours. ECG fixes extrasystole, atrial fibrillation.
   • acute pulmonary heart - pressure in the pulmonary artery rises, and as a result, the fluid begins to sweat into the lung tissue, which is why its edema develops. Pulmonary tissue tightens, and the right ventricle does not cope with the load. Clinic of this syndrome: tachycardia, pulsation in epigastrium, swelling of cervical veins.
   • acute cerebrovascular insufficiency - cerebral hypoxia develops due to the collapse, and when several blood clots are formed that can enter the brachycephalic arteries, and then the carotid arteries into the brain, cerebral edema develops. Symptoms: dizziness, noise in the ears, fainting, coma, convulsive syndrome.
2. Pulmonary-pleural:
   • acute respiratory failure - dyspnea, BH up to 40 per minute, diffuse cyanosis.
   • mild bronchospastic syndrome - wheezing rales are heard in auscultation.
   • lung infarction - develops on 1 -3 day. Complaints: shortness of breath, a damp cough with blood, pain in the chest.
3. Feverish:
   • is an inflammatory phenomenon in the lungs.
4. Abdominal:
   • swelling of the hepatic veins. Complaints of pain in the right upper quadrant.

Treatment of pulmonary embolism of the pulmonary artery

Resuscitative measures are carried out, which include excretion of the patient from a condition that threatens his life. In the future, restore blood circulation in general, normalize the pulmonary blood flow. Prophylaxis is carried out to prevent the development of chronic pulmonary hypertension. If necessary, prescribe oxygen therapy and fibrinolytic drugs. In inflammatory processes - antibacterial therapy.

Emergency assistance for pulmonary embolism is performed depending on the clinical manifestations, the developed symptoms are prevented on site by improvised medical devices, and the patient must be hospitalized.