What is a pulmonary embolism?

一种pulmonary embolism (PE) is a血块that occurs in the lungs.

由于：

  • restricted blood flow
  • decreased oxygen levels in the blood
  • 对其他器官的影响

Large or multiple blood clots can be威胁生命。However, immediate emergency treatment for a PE greatly increases your chances of avoiding permanent lung damage.

Explore the interactive 3-D diagram below to learn more about pulmonary embolism symptoms.

症状of a PE depend on the size of the clot and where it gets stuck in the lung.

The most common symptom of a PE isshortness of breath。这可能是渐进的或突然的。

Other symptomsinclude:

如果您注意到其中一种或多种症状，尤其是呼吸急促，则应立即寻求医疗护理。

Read more: How to tell if you have a blood clot.

血块可以出于多种原因形成。PES最常由deep vein thrombosis (DVT), a condition in which blood clots form in veins deep in the body. The blood clots that most often cause PEs begin in the legs or pelvis.

Blood clots in the deep veins of the body can have several different causes,including：

  • Injury or damage.诸如骨折或肌肉撕裂之类的伤害会对血管造成损害，从而导致凝块。
  • Inactivity.During long periods of inactivity, gravity causes blood to collect in the lowest areas of your body, which may lead to a blood clot. This could occur if you’re sitting for a lengthy trip or if you’re lying in bed recovering from an illness.
  • 医疗条件。某些健康状况使血液容易凝结，这可能导致PE。涉及手术的治疗通常会导致短期床休息或有限的运动，这可能会使凝结的可能性更大。此外，某些用于癌症的医疗疗法可能会产生副作用，例如血液中的凝血。这使您有DVT和PE的风险。

There are additional risk factors that increase your odds of having the type of blood clot that can cause PE.

PE has a wide variety of characteristics, ranging from no symptoms to sudden death. The most common presenting symptom is shortness of breath followed by chest pain and cough. However, many people with PE have mild or nonspecific symptoms or are asymptomatic, including people with a large PE.

When you talk with a doctor about your symptoms, they’ll ask about your overall health and any preexisting conditions you may have.

医生通常会执行以下一项或多项测试to discover the cause of your symptoms:

  • 胸部X射线。这是一项标准的无创测试，可让医生看到您的心脏和肺部寻找其他明显的症状原因。无法通过此测试诊断出PE。PE上最常见的发现胸部X射线is “normal.”
  • Electrocardiography (ECG).一个ECGmeasures your heart’s electrical activity. A PE can not be diagnosed on an ECG. This test will check for other causes of chest pain.
  • Computed tomography pulmonary angiography (CTPA).该测试是首选诊断成像方法，因为它对PE的诊断很敏感且具有特异性。但是，它需要使用静脉（IV）对比度。因此，肾脏问题的人可能无法进行此测试，因为对比可能导致或恶化肾脏疾病。当无法执行CTPA时，医生可以考虑进行VQ扫描以诊断PE。
  • 通风/灌注扫描（VQ）。一种VQ scanis carried out in two parts. In the first part, radioactive material is breathed in, and pictures are taken to look at the airflow in your lungs. In the second part, a different radioactive material is injected into a vein in your arm, and more images are taken to see the blood flow in your lungs. This is mostly reserved for when:
    • 您无法收到CTPA
    • the results of the CPTA were inconclusive
    • 需要更多测试
  • Magnetic resonance pulmonary angiography (MRPA).This is not recommended as a first-line test for diagnosing PE, but it may be an imaging option to diagnose PE in people who can neither receive a CTPA nor a VQ scan. Potential advantages of MRPA are that no ionizing radiation is involved, and the examination can be combined with MR venography in the same sitting to look for DVT.
  • Venography.一种venogramis an invasive test that is rarely used for the diagnosis of only a DVT. This is a specialized X-ray of the veins in your legs and also requires the use of contrast.
  • Pulmonary angiography.一种肺部血管造影是一种侵入性测试，很少用于诊断急性PE。它涉及进行小切口，以便医生可以通过静脉指导专用工具。医生将使用对比度看到肺中的血管。
  • 双工静脉超声。This is a practical and noninvasive test to only diagnose a DVT. It’s important to remember that you can still have a PE even if the ultrasound is negative for a DVT. This test uses radio waves to visualize the blood flow and check for blood clots in your legs.
  • D-二聚体测试。This is a type of blood test used to screen for signs of a PE or DVT based on the your probability of having a clot. A doctor can not make a diagnosis based on this blood test. If the result is positive, the doctor must confirm the diagnosis with the appropriate imaging method.

急性PE、肺部动脉堵塞,经常来回m a blood clot, is a common and sometimes fatal disease. When you’re evaluated for a PE, it’s often important for the evaluation to be efficient and avoid unnecessary testing so you can start therapy quickly.

Factors that increase your risk of developing DVT and PEinclude：

Read more: Learn about the risks of DVT。

Your treatment for a PE depends on the size and location of the blood clot. If the problem is minor and caught early, a doctor may recommend medication as treatment. Some drugs can break up small clots.

一种doctor may prescribe:

  • 一个ticoagulants.一种lso called blood thinners, medications such as heparin and warfarin prevent new clots from forming in your blood. They can save your life in an emergency situation. Another commonly used category of抗凝物是直接的口服抗凝剂（DOAC），例如Rivaroxaban（Xarelto）和Apixaban（Eliquis）。这些药物已获得FDA批准用于治疗和预防PE和DVT。
  • Clot dissolvers (thrombolytics).These drugs break down a clot to improve blood flow and perfusion. They are reserved for people hospitalized in emergency situations because side effects may include dangerous bleeding problems.

Minimally invasive procedures or surgery may be necessary if you’re unstable because of the problematic clots and you need urgent reperfusion to improve blood flow to your lungs and heart, especially when thrombolytics can not be used.

在肺栓塞的情况下，医生可能会使用一些程序include：

  • Catheter directed methods.These are used for clot removal and breakdown. A thin tube called a catheter will suction out, break down, or dissolve clots in your pulmonary artery.
  • Open surgery.医生只在紧急situati使用开放手术ons when:
    • 最小侵入性导管的定向方法不可用
    • medications aren’t working to break up the clot
    • 禁忌药物或为患者带来太多风险

一种fter you receive proper treatment for a pulmonary embolism at the hospital, you’ll be advised to treat the underlying cause of the PE or DVT if it’s known.

你会的most likely开始服用抗凝物medications, such as heparin, warfarin, or newer agents referred to asdirect oral anticoagulants (DOACs)，以防止血块返回。

定期锻炼双腿并练习促进健康的行为是PE后预防和治疗的关键组成部分。医生将为您提供有关如何照顾自己的完整说明，以防止将来的血块。

当血块到达肺部时，会发生肺栓塞。这些血凝块通常来自深静脉血栓形成，这可能是由于对骨骼和肌肉的损害或长期不活动而造成的。尽管进行了彻底的评估，但很多时候，DVT或PE的确切原因是未知的。

一种PE can be very dangerous, so it’s important to contact a medical professional if you’re experiencing symptoms such as chest pain, spitting up blood, and fainting.

医生通常会开处方使血液稀释的药物，在某些情况下使用破坏血凝块的药物。在某些情况下，可能需要进行最小的侵入性介入程序和手术。