Embolism

Question: What is the best way to prevent Air Embolism? I'm taking a SCUBA diving class at my college, and since I am OCD I keep on worrying and worrying about the Air Embolism they mention. Exactly what depth should you start worrying about AE and what is the best way to avoid having one? Is there any real danger of having one while doing "practice dives" in a swimming pool?

Answer: Air embolism or an arterial gas embolism can occur in as little as 4ft of water, although it is considered a leading problem in diving accidents and fatalities it is still extremely rare and I have never personally experianced or ever dove with anyone that it has happened to, and I have seen a few newbies hit the surface and come half way out of the water. There are people who are predisposed to this type of problem but it will usually show up early on when they begin diving in a mild case and prevent any future diving, a friend of mine had a patent foramen ovale which manifested itself at 50 ft after which he could never dive again. Other than physiological the most common cause is holding your breath on ascent which is invariably in a panic situation with a new or inexperianced diver, who forget to breath out as they rush for the surface. As for what depth you should worry about it? I have never worried about it and I have been to 185 fsw(feet salt water) on compressed air, but usually it is in the last few feet before the surface that the air pressure increases the quickest. For a full write up go to www.scuba-doc for more indepth information, http://www.scuba-doc.com/ageprbs.html This site will also provide just about all the info you would need to know about diving medicine. Also check out the DAN website http://www.diversalertnetwork.org/medica… Arterial gas embolism is a major cause of death in diving and the initiating cause (pulmonary barotrauma) usually goes undetected. Caused most often by the expansion of respiratory gases during ascent, it also occurs when the breath is held during ascent from a dive, when there is local pulmonary pathology, when there is dynamic airway collapse in the non-cartilaginous airways and if there is low pulmonary compliance, particularly if this is not distributed evenly throughout the lungs. Boyle's law is the physical law controlling the event. Experimental evidence indicates that intratracheal pressures of about 10 kPa (4 fsw or 1.22 m. or ascending from 170 feet or 51.82 m. to 120 feet or 36.58 m.) are all that's needed for it to happen. Distention of the alveoli leads to rupture, alveolar leakage of gas, and extravasation of the gas into the arterial circuit. In all diving is a fun safe sport which millions of people around the globe experiance every year, have some fun, practice safe diving exercises and remember to not hold your breathe on ascent and you will have a great time and many wonderful diving storyes and experiance to tell your kids when you get older.

Question: What is the difference between an aneurysm and an embolism? Is the difference where they happen (head versus body), between hitting a vein or artery, or how serious the damage is? Can a cerebral accident be both an aneurysm and an embolism at the same time?

Answer: Yes. An aneurism is the ballooning of a blood vessel, and it can rupture due to a weak vessel wall. An embolism is a clot floating around in the bloodstream, and is critical when it reaches either the brain or the heart. Elsewhere, it may cause a stroke/paralysis.

Question: What are symptoms of a pulmonary embolism? Hi. A couple of years ago I went to the doctors about a cough I've always had. They did blood work and a chest X-Ray but found nothing. Now recently I found out that my mothers father died of a pulmonary embolism at the age of 33. What I'm wondering is if this cough I have is related to a pulmonary embolism. Also, is a pulmonary embolism genetic?

Answer: The symptoms of pulmonary embolism include (in rough order of prevalence) pleuritic chest pain (pain worst in breathing in), shortness of breath, fever, fast heart rate, cough with/without blood. Large pulmonary emboli can result in low blood pressure and the attendant symptoms - dizziness, blackouts, loss of consciousness, etc. A cough without any other of the above symptoms is quite unlikely to be due to a pulmonary embolus. The tendency to form blood clots (and hence having a higher risk of embolus) can indeed be genetic - there are blood tests to screen for some of the more common conditions, but having a normal test doesn't mean that you are not at increased risk, particularly given your family history. Aspirin is a cheap drug that may be beneficial in lowering your risk of a pulmonary embolus - but I would hasten to add that there is no solid trial evidence for its effectiveness in this context.

Question: if someone has Pulminary Embolism would they qualify for SS benefits or Disability benefits? I have Pulminary Embolism, Pulmonary embolism is the sudden blockage of an artery in the lung. Once the artery is blocked, usually by one or more blood clots, oxygen levels in the blood drop, and blood pressure in the lungs rises. Pulmonary embolism caused by large clots can cause sudden death, usually within 30 minutes of when symptoms begin. Smaller clots may cause permanent damage to the heart and lungs.

Answer: While what you wrote is true, it's not necessarily debilitating in the long term. It could take several months to completely dissolve the clots, but once dissolved you could be your old self again. I had bilateral pulmonary embolisms in '93 and after having an IVC filter (inferior vena cava filter) implanted, I recovered fully in about 6 months. I was back to work after 2.5 months. While there was a risk that I'd develop Right Ventricular Hypertrophy due to the strain on my heart caused by the clots, I was lucky and had no hypertrophy. I hope you are as fortunate. If you are likely to have more clots in the future, you should discuss having an IVC filter implanted. It doesn't hurt and it protects you against any clots that develop below the location of the filter.

Question: When is it safe to travel after a pulmonary embolism? A friend visiting from Europe developed a pulmonary embolism after a surgery. She has been started on a blood thinner. When is it safe for her to fly back home?

Answer: Never. She needs to become an American citizen and stay here forever. Or at least take a boat home and not a plane. LOL

Question: Is it possible to get a Pulmonary Embolism while on Warfarin if you've already had one? I sufford from a Pulmonary Embolism while is hospital about 3 months ago. I am now on Warfarin for 6 months but I am wondering is it possible to get another Pulmonary Embolism whilst on it. Every time i get shortness of breath or pain in my leg i panic! Sensible answers only please! Also, after Warfarin, will i be at a greater risk of getting one even if I'm active?

Answer: It is possible, but not likely. When you're on warfarin, you should be having blood tests called a P.T. (Prothrombin Time) and a P.T.T. (Partial Prothrombin Time) which lets your Dr. know if you're blood is anti-coagulated enough. That way the Dr. can adjust your dose when needed. I had a blood clot in my leg that broke off and went into my lungs and my MD had me take these tests weekly for 10 years. I felt the same way you do for many years, but if you have these tests done, that should make you feel less panicked. Also, there is a new injectable medication now called Lovenox, which acts immediately. If you're not having these tests done, you should be.

Question: What are the chances of having another stroke and pulmonary embolism if you smoke weed? I suffered a stroke and pulmonary embolism three months ago? I dont smoke cigarettes or drink alcohol but I did used to smoke weed?

Answer: ScienceDaily (June 14, 2001) — BOSTON – Researchers at Beth Israel Deaconess Medical Center and their colleagues have found that people who smoke marijuana may increase their risk of a heart attack. In a study of nearly 4,000 people who had suffered a heart attack, the researchers observed that a person’s chance of having a heart attack, particularly those who are already at risk for heart disease, increased nearly five times during the first hour after smoking marijuana. http://www.sciencedaily.com/releases/200…

Question: What is the difference between an embolism and a stroke? or are they the same thing? Not sure if they are the same thing or different. Or is an embolism the cause of a stroke? Thanks for any info

Answer: Not quite the same, an embolism is a travelling wad of something, usually a blood clot, that will end up at the terminus of a blood vessel. If that vessel is in the brain or supplies the heart, etc, there may be a big problem because enough blood will no longer supply that area. A stroke can be due to not enough blood flow, either from an embolus, or constriction of blood vessels without an embolus, or may also be from hemorrhage (bleeding). So an embolus can cause a stroke if the clot (or fat or air or whatever comprises the embolus) ends up in the brain.

Question: Why does pulmonary embolism cause increased heart rate? I am trying to figured out the pathophysiology of a pulmonary embolism. Why does it increase heart rate?

Answer: The embolism impedes and so degrades the process of oxygen uptake, (-perfusion), in the pulmonary flow, necessitating a greater cardiac output (or total systemic loop flow, TSLF) to equate demand and supply of oxygen to the organs. Increased CO is achieved in two ways, (a) increasing stroke volume and (b) increasing heart rate. The increased HR is obvious and visible, but the increased SV is only detectable by observable increased pulse pressure. This is because pulse pressure is proportional to stroke volume, from the equation SV = C.PP where C is the compliance of the ascending aorta. EDIT: I'm most grateful for John's posting, and think we're talking about the same process from different viewpoints. Since your question was on the raising of heart rate caused by pulmonary embolism and its pathophysiology, my answer focussed on that aspect I note that the other posting concurs in this. The flow through the perfusive tissue is where my imperative lies, -not the pulmonary arteries. This is bound to impede the oxygen uptake of whatever residual blood throughput remains, and thus demand will increase, causing the HR rise you describe. We are agreed on that. But the point I was making is that SV usually increases too, provided the heart is capable of raising it , leading to a raised pulse pressure and by extension, systolic pressure too, but it's not immediately apparent, since this process is only detectable clinically by observation of PP. If the heart's pump-function is impaired however, and it is unable to deliver the required CO at the required pressure, then both PP and PD may even fall, despite the rise in HR.

Question: I recently had a pulmonary embolism, currently on warfrin. What are the risks of getting pregnant? I am concerned about what complications might arrise if I were to get pregnant after my warfrin treatment. Complications for the baby and for myself...Is it ok to have another child after a pulmonary embolism and being on warfrin or are there too many risks invloved?

Answer: I have a genetic blood clotting disorder. The disorder predisposes me to having DVT's. I've had 4. Luckily, they were caught early and didn't end up going into a pulmonary embolism. Each time, I was placed on coumadin (warfrin) for at least 6 months. The first time I got pregnant, I was on the blood thinner. I found out I was pregnant at 6 weeks. I miscarried 2 days later. I lost so much blood, I needed transfusions. My doctor told me Warfrin causes miscarriages in a lot of women. He advised that if I wanted to become pregnant, to stop the Warfrin and start Lovonox injections instead. The injections have to be given in the stomach every day, usually twice a day. They hurt a lot. There is intense burning feeling afterwards for a couple of hours. Most injection sites bruise badly. Having had a blood clot, that makes you high risk, so they will insist on the shots every day for the entire 9 months of pregnancy and after if you want to breastfeed. The downside of Lovenox is that it is very expensive. Over $3000.00 for a month's supply retail. If you have Medicaid, they'll pay for all of it. If you have private insurance with a prescription copay, you'll just have your copay, unless you hit the max for prescriptions in a year. They will probably insist on a planned C-section, because your heart and lungs probably won't deal very well with the strain of labor. They won't let you have an epidural and be awake during it, though. You'll get general because of the risk of bleeding around your spine from the Lovenox, iif they gave you the epidural. Bed rest for the last 6 months of the pregnancy is very probable, too. Been there, done that. I've had 2 children that are both very heathy toddlers, now. They are 17 months apart in age. I had Lovenox shots with them both, bed rest for 6 months with my first, 4 with the second. If you really want another child and are willing to deal with the risks, it is very very worth it. As for getting pregnant on warfrin, highly risky....you'll miscarry 80 percent of the time....birth defects for the other 20. Lots of blood loss for you, could be very serious, if not fatal. Stop the warfrin, go on Lovenox ...then get pregnant, is a better option.

Question: How do you explain an air embolism in a 16 year old? 16 year old male, taking unknown weight loss supplement for 1 year, develops chest pain/ shortness of breath while weight lifting, is ultimately found to have an air embolism in his right ventricle. Had no recent venous access, no surgeries/procedures, no prior medical history. How could this have happened??

Answer: Weight Lifting? I may be 100% wrong, but he could be abusing steroids. You know when you watch a medical program and they spray liquid out of a syringe and then tap the end of the needle? Well, that's to get rid of the air bubbles and to prevent air embolisms. If you're 16 year old shot them self up with riods and didn't do this, then they could easily have given them self an air embolism.

Question: Is a Pulmonary Embolism the same thing as a heart attack? I'ms tudying for a fnial, and I know a myocardial infarction is the same thing as a heart attack, and the pulmonary embolism is incredibly similar to both in definition. I'm looking for somebody to clarify for me. Thanks guys. that cleared it up. the pulmonary part shoulda given it away.

Answer: A pulmonary embolism is a blood clot in the lung, which will certainly kill you but it's not a heart attack.

Question: How to tell difference between hemorrhage or embolism stroke? The symptoms of the two types of stroke, where one hemorrhages blood into brain killing portions of it. Or has an embolism clot that lodges somewhere depriving brain or cells of blood. They apparently can be difficult to distinguish initially. yet how someone dealing with one of them responds can be difference between severe disability and death or life and possible full recovery. So, how can one tell which one someone is experiencing for oneself? If possible within first 30 minutes of the "magic window"? Or discern which someone else is having? And how do we respond to either one to prevent further damage and maybe reverse damage, even if we are not near a hospital or professional medical help? People are answering as if an er is available. But i am asking based on how to tell the difference and deal with if we are NOT able to get to a hospital or be reached by ambulance.

Answer: You call 911 and rush them to the hospital. They do a CT and find out if it is Hemorrhagic or embolistic. We answer this way, because it is the only option. You do not know unless there is a CT done. Treatment depends on the cause. If you do not know the cause, NO TREATMENT can be done!!!

Question: Is it possible for a fart to go into the vagina and cause an embolism? This is not a joke. I just want to know if a fart can somehow go into the vagina and cause an embolism in pregnant women. I know that blowing into the vagina can cause this. I am just wondering if it's possible that a fart can do the same thing. Please only serious answers.

Answer: Although I have had farts pass by my vagina, I seriously doubt that one could enter. There isn't enough air pressure for one to enter. Even if it did, the worst that would happen would be getting a stinky queef.

Question: Does anyone know anything about a pulmonary embolism in dogs? I rescued a dog a couple months ago. She had heartworms before I got her and we plan on treating her but we were trying to get her in good health. She has had a pulmonary embolism from one of the worms. Does anyone know a good antibiotic I can use or other things? I am a vet tech but I am having trouble finding the right thing to help. Any advice?

Answer: don't you think the vet you work for would be the best person to ask this question? As a vet tech you would know more about this than we would.

Question: Why is a Pulmonary Embolism bad for you? I have a blood clot in my aorta veins and the doctors were so concerned that I might have a pulmonary embolism already had a cat scan of my chest and everything was fine I just got off lovenox shots and take coumadin once a day.

Answer: Symptoms and Complications The symptoms of pulmonary embolism can be mild or severe. Some people have many small emboli that can only be detected by special X-ray techniques. A serious blockage, however, can lead to severe breathing difficulty or death. Symptoms of pulmonary embolism appear suddenly and include: shortness of breath, rapid breathing, or wheezing bloody sputum cough lightheadedness, dizziness, fainting sharp chest pain or back pain http://www.medbroadcast.com/channel_cond…

Question: How bad is a pulmonary embolism? So my dad has just been admitted to the hospital for a pulmonary embolism, which is a blood clot in his lung. Can anyone tell me how bad these are? He had open heart surgery about a year ago because he had a leaking heart valve. He had a seizure about a year ago but they were never actually sure if it was a seizure or a stroke. He takes blood thinners everyday since his heart surgery. Thanks in advance for your help. My dad already takes cumiden. He has been taking it for a year since his heart surgery.

Answer: Pulmonary embolisms are potentially life threatening - the seriousness is almost pure chance. If a clot is big enough or lasts longs enough to block the blood flow in the pulmonary artery, it usually triggers a severe or fatal heart attack. The blood thinners probably saved your dad's life, or at least kept the embolism from causing any additional problems. An embolism doesn't have any lasting effects - whatever damage it did, if any, occurs within a few minutes. Otherwise, the only lasting danger is the risk of having another embolism in the future.

Question: Is there a high mortality rate for someone suffering from a pulmonary embolism? Someone i know is in hospital with a suspected pulponary embolism, should i be very worried and would he be likely to die from it and how long would it take to see signs of improvement and how would he be treated?

Answer: Hi Paul, Sorry to hear that someone you know has had a pulmonary embolism (PE). Just like any medical condition, there is wide variability in the severity of a PE so it is difficult to give an exact figure for mortality rates. The most commonly quoted figure amongst textbooks is 5% for patients treated with anticoagulation and 30% for those who are not. It is important to bear in mind that these figures also encompass people who die immediately from a massive PE, so if the person you know is a few days post PE and recovering well then this is more encouraging than a 5% mortality statistic. Treatment depends on how severe the PE is and how early it is caught. Patients with a massive PE who present early may be suitable for thrombolysis (commonly called "clot busting"). However, all patients require anticoagulation (blood thinners) to reduce their risk of developing further PE's (as a previous PE is a risk factor for developing subsequent and potentially more serious PE's). There are numerous ways of thinning someones blood. Usually people are put on either low molecular weight heparin (LMWH) or Fondoparinux which is given by injection in to the fat on the belly or top of the legs. Many people are then considered for warfarin, which is more convenient as it is a tablet but may not be suitable for everyone and requires regular blood checks to make sure the blood isn't too thin. I hope the person you know is recovering well and that you found this helpful. If you have anymore questions, the Patient UK website is an excellent source for information (link below). http://www.patient.co.uk/doctor/Pulmonar… Rhys.

Question: Would a pulmonary embolism have shown up on a chest x-ray? I recently had a chest x-ray to look at my lungs. Would a pulmonary embolism have shown up?

Answer: PE is not seen on chest x-ray. PE is a clot in the blood vessels of the lungs. The best imaging is CT angiogram which involves injecting contrast dye into the veins and doing a CT, if there is a blockage the dye will not be in the blocked vessel and it can be diagnosed.

Question: How is embolism, varicose veins and epilepsy contra-indicated in a massage? i am doing a massage course and i cannot find out on the internet why embolism, epilepsy and varicos veins are contraindicated in a massage, please help!!!!!!!!

Answer: Hi. Here is a link to check out regarding massage and epilepsy. I am a massage therapist and also have a seizure disorder. THere are many people out there who have a seizure disorder and don't really talk about it. It is a good idea to check w/ the person to find out what types of seizures they have. For the most part, massage is contraindicated for clients w/ epilepsy/seizure disorder because if someone were to have a seizure while on your table, it could be a difficult situation to handle and there is fear that the client or therapist could be injured. It all depends on the type of seizures.(Not all seizures involve falling to the ground and having convulsions, some consist of a person kind of "spacing out" and these can last as little as a few seconds. This link has a really good description . . . http://en.allexperts.com/q/Massage-1818/… re:embolism, blood clots, varicose veins fall into that category as well because the increased blood flow to that area could aggravate an already present blood flow issue. When someone fills out their forms, and checks any of these off on their new client sheets, I always ask for a note from the doctor to ok massage . . . for varicose veins, I tell people that I cannot work distal to the veins for risk of dramatically increasing the blood flow through that area.