Pulmonary thromboembolism: understand the causes and risks of the health problem

Venous thromboembolism is characterized by the presence of a thrombus or clot in the circulatory system. The condition manifests itself in two ways: deep vein thrombosis (DVT), which affects a deep vein in the lower limbs, and pulmonary thromboembolism (PTE), which is the third leading cause of cardiovascular death.

The health problem occurs when the clot travels through the bloodstream and lodges in the arteries of the lung, which makes it difficult to oxygenate the blood. The aggravation is associated with heart overload, which can lead to myocardial infarction and death.

The development of the disease is related to lack of mobility, such as sitting or standing for long periods and routine situations in work environments, as explained by pulmonologist Elnara Negri, from Hospital Sírio-Libanês.

“The causes can be genetic, medication, in general the use of contraceptives can be linked to these conditions. Smoking is also a factor that can increase the frequency of thrombosis. On long trips, mainly by air, with a lot of immobilization time, they can also increase the chance of such a situation. Another factor is the postoperative period, when you also have a greater chance of having these clots form,” says Elnara.

The president of the Brazilian Society of Angiology and Vascular Surgery – Regional São Paulo, Fabio Rossi, explains that there are other risk factors, such as obesity, heart and kidney failure, autoimmune diseases, smoking, cancer, trauma, central venous catheter, varicose veins in the lower limbs, genetic causes and infectious diseases such as severe viral and bacterial infections.

Despite manifesting itself with a higher incidence in older people, venous thromboembolism can also affect younger people due to harmful habits, such as smoking, including the use of electronic cigarettes, and sedentary lifestyle. Women, both younger and older, who use contraceptives or undergo hormone replacement, are pregnant or postpartum, have a higher chance of developing the condition than men.

Symptoms

The most common symptoms of venous thromboembolism are pain, swelling, heat, redness and hardening of the tissue in the affected limb. In cases of pulmonary embolism, the signs are cough, chest pain, bloody sputum, palpitations, fainting and even cardiorespiratory arrest in the most serious cases.

Rossi adds that it is essential that suspected cases are immediately investigated, and if confirmed, the use of anticoagulants is immediately prescribed. According to the doctor, without a correct and immediate diagnosis and treatment, the problem can lead to serious complications, with cardiac arrest and, consequently, death being the most critical condition, which happens in 19.6% of cases of massive pulmonary embolism.

“It is a highly serious disease because it can progress and lead to respiratory failure and cardiac arrest. It requires urgent care and treatment depends on the size of the clot and its position. Anticoagulants and agents that destroy the thrombus, thrombolytics, are used, always under medical indication and supervision”, says the pulmonologist.

In a late and chronic phase, partial obstruction of the arteries of the lung can lead to chronic thromboembolic pulmonary hypertension, a frequent cause of loss of quality of life that affects 2 to 4% of surviving patients.

The diagnosis is made with the aid of tests, with vascular Doppler ultrasonography indicated in cases of suspected thrombosis, and computed tomography in cases of pulmonary embolism.

“In addition to anticoagulation, which must have medical supervision, as there is a risk of hemorrhage, in severe cases, when there is a risk of death, there is an indication for immediate thrombus dissolution, which can be done by infusion of intravenous medication, or by aspiration with catheterization techniques, which have been presenting promising clinical results, with a reduction in the risk of bleeding”, says Rossi.