A pulmonary embolism occurs when a blood clot moves through the bloodstream and becomes lodged in a blood vessel in the lungs. Similarly, in a condition called deep vein thrombosis, clots form in the deep veins of the body, usually in the legs. A blood clot that breaks free and travels through a blood vessel is called an embolism. In either case, you’ll need medical treatment right away to prevent a blood clot from blocking blood flow to your lungs or your heart.
According to the CDC, between 60,000 and 100,000 Americans die every year from deep vein thrombosis or pulmonary embolism and as many as 900,000 people could be affected.
Sometimes these conditions are present with no symptoms at all. Otherwise, symptoms may include swelling, pain, and tenderness, often in the legs. Risk factors include hormone therapy, pregnancy, and extended periods of immobility such as a long car or plane trip.
Symptoms of Deep Vein Thrombosis or Pulmonary Embolism
Call your doctor right away if you have these DVT symptoms, especially if they appear suddenly:
Swelling in one or both legs
Pain or tenderness in your leg, ankle, foot, or arm. It might feel like a cramp or charley horse that you can’t get rid of. Leg and foot pain might only happen when you stand or walk.
Warm skin on your leg
Red or discolored skin on your leg
Veins that are swollen, red, hard, or tender to the touch that you can see
Symptoms of an urgent condition include:
Sudden coughing, which may bring up blood
Sharp chest pain or chest tightness
Pain in your shoulder, arm, back, or jaw
Rapid breathing or shortness of breath
Pain when you breathe
Tests Your Doctor May Order to Diagnose Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE)
Your doctor will usually begin by obtaining your medical history, as this may provide information about factors that caused the clot. In addition to performing a physical exam, your doctor may order one or more of the following tests:
Blood tests, such as D-dimer: This test looks for a protein that shows up in your blood when a clot starts to break down. If you have a clot, levels will be high.
CT Angiography: This non-invasive CT scan uses x-rays and an iodine-containing contrast material to produce pictures of the chest highlighting the blood vessels in the chest and lungs.
Magnetic resonance imaging (MRI): You’ll lie still on a table while radio waves and a strong magnetic field make detailed pictures of the inside of your body on a computer. (You’ll hear loud tapping or knocking sounds during the test.) You might need to get an injection of contrast material to make your blood vessels show up better. An MRI can find DVT in your pelvis and thigh.
Venous ultrasound: This test uses sound waves to confirm the presence of a blood clot. Doppler ultrasound is a special technique that allows the doctor to see and evaluate blood flow through arteries and veins throughout your body. If the results are inconclusive, your doctor may use venography or MR angiography.
Venography: This is a special X-ray. The doctor injects a radioactive dye into a vein on the top of your foot to help them see your veins and maybe a clot.
V/Q Lung scan: This nuclear medicine exam uses a small amount of radioactive material (called a radiotracer) and a special camera to create pictures that show how blood and air are flowing throughout the lungs.
Ultrasounds are a very common form of medical imaging. They are painless, offer no risk of radiation, and can provide details of the interior of the body without making a single incision. However, there are various kinds of ultrasounds that can be administered for different parts of the body for different conditions.
Most people are aware of ultrasounds in relation to pregnancy. Ultrasounds use sonar power or sound waves in order to create images of internal organs without having to make incisions or use contrast material. Sound waves reverberate off the organs and bones and the ultrasound machine interprets the change in sound waves and uses computer technology to make an image. Because of the comfort on the part of the patient in concert with the information gleaned for doctors, ultrasounds are now able to do so much more.
Common Ultrasound Exams and How They Help You and Your Doctor
Abdomen: Most often ultrasound is used in the abdomen to see the abdominal aorta, bladder, liver, pancreas, and spleen.
These exams will help your physician investigate blockages, pain, enlargement, malformation, narrowing of vessels, tumors, or abnormal function.
Appendix: When bacteria in the appendix are blocked from leaving, the appendix becomes irritated. Ultrasounds can help doctors determine the extent of the infection.
Carotid Doppler/Vascular: Doppler ultrasound can map the movement of blood through veins and arteries in the body. This is extremely useful if there is a possible blockage in the artery. Blood blockages are what cause conditions such as strokes, heart attacks, amputations, and other kinds of problems. The most common places to perform a Doppler ultrasound are at the neck and abdominal arteries leading to and from the brain and heart, mainly the aortic and carotid arteries. During this exam, the transducer (ultrasound wand) is held against the neck with ultrasound gel to prevent air pockets from forming as sound cannot penetrate the air. Patients report hearing pulse-like sounds when the procedure is happening. A carotid Doppler ultrasound differs from other forms of ultrasound because it measures the direction and speed of blood cells as they move throughout the vessels. The movement causes a change in the pitch of reverberating sound waves. This way doctors can tell if there is a blockage or damage to the vessel that could be detrimental to the healthy blood flow needed in the body. If you are concerned about cardiovascular health or high blood pressure, your doctor might consider having one of these ultrasounds performed. If you are aware that you are at high risk for heart attack or stroke, having crucial medical information gained from ultrasounds could save your life. Vascular ultrasounds help identify blockages in the arteries and veins and detect blood clots. This exam can help your doctor determine whether you are a good candidate for angioplasty procedures. Doctors use this exam to diagnose and evaluate varicose veins.
DVT/Venous: Clots that occur in larger veins are called deep vein thrombosis (DVT). Blood clots can also occur in smaller veins that are closer to the skin. Symptoms of blood clots in the legs and arms vary and may include pain or cramping, swelling, tenderness, warmth to the touch and bluish- or red-colored skin. A blood clot can be life-threatening depending on the location and severity. Venous ultrasound: This test is usually the first step for confirming a venous blood clot, especially in the veins of the leg. Sound waves are used to create a view of your veins. A Doppler ultrasound may be used to help visualize blood flow through your veins. If the results of the ultrasound are inconclusive, venography or MR angiography may be used.
This condition is often referred to as deep vein thrombosis or DVT (see above). A venous ultrasound study is also performed to determine the cause of long-standing leg swelling.
Gallbladder: Ultrasounds can determine the presence of gallstones which form when bits of cholesterol and others materials in bile combine to form solid masses.
Kidney and Kidney Stones: Kidney and bladder stones are solid build-ups of crystals made from minerals and proteins found in urine. Certain bladder conditions and urinary tract infections can increase your chance of developing stones. Your doctor may use an abdominal and pelvic CT scan, intravenous pyelogram, or abdominal or pelvic ultrasound to help diagnose your condition. If a kidney stone becomes lodged in the ureter or urethra, it can cause constant severe pain in the back or side, vomiting, hematuria (blood in the urine), fever, or chills.
Thyroid: Ultrasounds use sound waves in order to interpret the inner happenings of the body, including checking to see if the thyroid contains a cyst or tumor.
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