Balaji Balagani: Exploring Pulmonary Embolism
Balaji Balagani, Cardiologist in Guntur, GKNM Hospital, shared a post on X:
“Pulmonary Embolism (PE) – Simple Medical Explanation
Pulmonary embolism (PE) is a sudden blockage of one or more arteries in the lungs, most commonly caused by a blood clot that travels from the deep veins of the legs or pelvis (called Deep Vein Thrombosis).
Simple mechanism
- A blood clot forms in a deep vein (usually the leg).
- Part of the clot breaks off.
- It travels through the veins – right side of the heart – into the pulmonary arteries.
- The clot blocks blood flow to part of the lung.
- The affected lung receives air but little or no blood, reducing oxygen exchange.
- A large clot increases pressure on the right side of the heart and can lead to right heart failure, shock, or sudden death.
Common symptoms
- Sudden shortness of breath
- Sharp chest pain (often worse with deep breathing)
- Rapid breathing Fast heart rate Cough (sometimes with blood)
- Feeling faint or collapsing (in massive PE)
Risk factors (Remember: Virchow’s Triad)
- Stasis: Prolonged bed rest, long flights, surgery
- Hypercoagulability: Cancer, pregnancy, oral contraceptives, inherited clotting disorders
- Endothelial injury: Trauma or recent surgery
Diagnosis
- D-dimer (helps rule out PE in low-risk patients)
- CT Pulmonary Angiography (CTPA) – the test of choice ECG and chest X-ray (supportive but not diagnostic)
- Ultrasound of the legs to detect DVT Echocardiography in unstable patients to assess right heart strain
Treatment
- Immediate anticoagulation (blood thinners), such as Heparin followed by long-term anticoagulants.
- Thrombolytic therapy (clot-busting drugs) for massive, life-threatening PE with shock.
- Catheter-directed clot removal or surgery in selected patients.
- Inferior vena cava (IVC) filter if anticoagulation cannot be given.
Prevention
- Early walking after surgery Compression stockings or intermittent pneumatic compression
- Preventive anticoagulants in high-risk patients
- Staying hydrated and moving during long travel
Exam pearl
Pulmonary embolism – A blood clot travels from the leg veins to the lungs, blocking blood flow.
This causes sudden breathlessness, chest pain, and can strain the right side of the heart.
Early diagnosis and anticoagulation are lifesaving.:”
Proceed to the video attached to the post
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