When a pulmonary embolism is not resolved and becomes a chronic condition, what are the long-term effects?
It depends on the size and location of the embolism as well as other aspects of the patient’s health. Because of the potential danger of pulmonary emboli, doctors usually prefer to get rid of them. Preventive measures will be taken for people who are at risk for one embolism or recurrences.
An embolus is a clump of material that flows in the bloodstream. It can be made of fat, bone marrow, an air bubble or other materials, but most pulmonary emboli are blood clots that start out in the legs. Known as a thrombus, a blood clot may travel through the bloodstream from the legs and back toward the lungs and heart. If it lodges in a blood vessel in the lungs, it is called a pulmonary embolism.
When a pulmonary embolism is large, it can completely obstruct the blood vessel it is in and keep the blood supply from a portion of the lung. Deprived of oxygen, that section of lung tissue dies, causing a certain amount of permanent damage to the lungs. This happens in only a small percentage of pulmonary embolism cases, but it can be fatal.
A chronic problem usually indicates that the person has small emboli. This can lead to shortness of breath, swelling and pain in the lower legs and chest. Reduced blood flow through the lungs makes the heart work harder at pumping blood.
The first course of treatment for pulmonary emboli is usually anticoagulant medication and oxygen. If this does not seem to be helping or the person is at risk of a fatal embolism, the next step may be thrombolytic drugs, known as clot-busters. In some cases, the embolism is surgically removed from the pulmonary artery. Another last-resort measure is placing a filter in the vena cava, the main vein that returns blood to the heart. The filter keeps emboli from passing through to the lungs or heart.
Preventive measures can be used simultaneously. They may include wearing elastic stockings to increase circulation, exercise and weight loss. A person who is at risk should avoid sitting in one place with the feet down for longer than about 15 minutes at a stretch.