|Pathway of Pulmonary Embolism|
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- Blood clot in a deep vein of a leg or the pelvis
- Increased levels of clotting factors in the blood
- Prolonged bed rest
- Major surgery, especially after pelvic surgery, knee replacement, or heart surgery
- Injury to a vein in a leg or the pelvis
- Fractures of the hip or thigh bone (femur)
- Certain blood disorders
- Prolonged sitting, such as during a long trip
- Pregnancy or postpartum period
- Inflammatory bowel disease
- Autoimmune disorder (for example, immune thrombocytopenic purpura, polyarteritis nodosa, or polymyositis)
- Taking certain medicines, such as birth control pills or antipsychotics
- Arterial blood gas study—a blood test to check oxygen levels and lung function
- Chest x-ray—a picture of the lungs to look for signs of dead tissue; the pulmonary embolism cannot be seen on the chest x-ray
- Lung perfusion scan—a test that measures breathing and circulation in all areas of the lungs (an embolus will cause a mismatch between the lungs)
- CT scan of the chest—detailed pictures of the inside of the chest
- Pulmonary angiogram—a special dye can highlight the areas of blockage in the lungs
- Magnetic resonance (MR) angiography
- EKG—a test to look for abnormal rhythms in the heart (such as rapid heartbeats)
- Echocardiography—a test to examine the size, shape, and motion of the heart
- D-Dimer (a clot-dissolving substance) blood test—increased levels in the blood may suggest the presence of a clot
If you have a family history of blood clots, and had blood clots in the past for no apparent reason, your doctor may do additional blood tests. The tests will look for possible inherited defects in your clotting system, such as:
- Factor V Leiden mutation (seen in up to 40% of cases)
- Increased factor VIII
- Additional tests may be done to check blood flow or look for clots in your veins. These tests will most likely be done in your legs.
- Enoxaparin (Lovenox)
- Fondaparinux (Arixtra)
- Eat a healthful diet that is low in saturated fat and rich in whole grains, fruits, and vegetables.
- Begin a safe exercise program with the advice of your doctor.
- Walk or move your legs to break up long periods of sitting.
- If you smoke, quit.
- Unless you are on a fluid-restricted diet, be sure to drink lots of water.
- Take medicine if your doctor recommends it. Anticoagulant drugs are most commonly used.
- Wear elastic stockings (also called support hose) if suggested by your doctor. They can help improve circulation in your legs.
- Walk or move your legs to break up long periods of sitting. If you are traveling, get up and walk every few hours.
American Lung Association http://www.lung.org
American Society of Hematology http://www.hematology.org
Canadian Lung Association http://www.lung.ca
Health Canada http://www.hc-sc.gc.ca
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10/5/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Parker C, Coupland C, Hippisley-Cox J. Antipsychotic drugs and risk of venous thromboembolism: nested case-control study. BMJ. 2010;341:c4245.
12/17/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Grainge MJ, West J, Card TR. Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study. Lancet. 2010;375(9715):657-663.
1/26/2012 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Zöller B, Li X, Sundquist J, Sundquist K. Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden. Lancet. 2012;379(9812):244-249.
- Reviewer: Brian Randall, MD
- Review Date: 09/2012 -
- Update Date: 00/93/2012 -