Pulmonary embolism (PE) is embolism of branches or trunk of the pulmonary artery thrombotic masses. Until recently, the concept of pulmonary embolism associated with the concept of pulmonary infarction. This pathology is considered to be relatively rare, having a clearly defined clinical and radiological picture.
In recent years, with improved knowledge of clinical and diagnostic techniques of lung disease revealed that pulmonary infarction – is only a small, above-water part of a massive iceberg in the modern human pathology, which is a pulmonary embolism. This disease occurs under all sorts of clinical masks, frequently diagnosed: pneumonia, chronic bronchitis, bronchial asthma, lung abscess, myocardial infarction, etc.
Symptoms of PE depend on the location and size of thrombi in the pulmonary artery. The most common symptom is shortness of breath (frequent and shallow breathing). Also, symptoms of pulmonary embolism may be increased respiration rate, expressed as anxiety, chest pain, often migrating to the scapula, arm, neck and jaw, cough, often mixed with blood, weakness, fainting, and heart palpitations. It should also be remembered that in rare cases, asymptomatic pulmonary embolism.
Risk factors for developing deep vein thrombosis, pulmonary embolism following: hereditary factors; congenital abnormalities of blood coagulation; large abdominal operations; fractures, particularly of the lower extremities; fixed position for a long time (sitting or standing), for example during a long flight or in the management of auto; cancer; obesity; smoking; previous heart attacks or strokes in history; pregnancy; use of oral contraceptives or replacement hormone therapy (estrogen).
Difficulties in the diagnosis of this disease are related to the fact that pulmonary embolism in more than 75% of patients is the companion of many difficult the case of other systems, especially cardiovascular, when clinical signs of the disease symptoms of blocked background pathology. PE is a frequent disease among patients with lesions of the lungs in a general hospital; it should be excluded in patients with pneumonia, pleurisy, myocardial infarction.
For the occurrence of this disease requires a blood clot in the pulmonary artery. It can be formed in the basin of the pulmonary artery autochthonous and serve in a subsequent embolus of this vessel, but in most cases the thrombus entered the venous system of a large circle or heart cavities.
The pulmonary artery is a kind of total filter blood in the body. Consequence of the evolution of the formation of the body was that the pulmonary trunk has a maximum diameter compared to other vessels, is the widest blood vessel. This fact excludes the possibility of incompatible with life at its total floor skidding blood clots in other vessels due to their smaller diameter. Therefore, the initial localization of a blood clot (embolism) was observed, as a rule, or the ramifications of the major branches of the pulmonary artery. In addition, the pool of pulmonary vessels is a powerful system meltdown (lyse) blood clots. Consequently, not every case of skidding thrombus leads to ischemia and implemented in these or other clinical manifestations of disease. For the occurrence of pulmonary embolism, in addition to drift a blood clot in them requires a number of specific conditions that make specific content etiology. PE is acute emerging, rapidly developing, and some patients with the duration of the current stage formation of different morphological and functional lesions of pulmonary process.
Pulmonary embolism of small branches of pulmonary artery without recurrence is usually a relatively favorable prognosis, with consequences that depend on the type of complications and outcome of it. In recurrent course possible long-term course of the process with progressive lung damage, the development of post thromboembolic pneumosclerosis with progressive pulmonary hypertension and the development of chronic pulmonary heart syndrome.