Pulmonary embolism. Information for patients Specialised Medicine

Transcription

1 Pulmonary embolism Information for patients Specialised Medicine

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3 What is a pulmonary embolism? A blood clot that has formed inside one of your veins, usually in your leg, is called a deep vein thrombosis (DVT). A pulmonary embolism (PE) is a piece of blood clot that has broken off from where it was originally formed and travelled to the lungs. It causes chest pain and breathing problems. The blood clot will stay in your lungs until it dissolves. It will not travel anywhere else in your body. The blood clot prevents your lungs from working to their full capacity so to compensate for this your breathing may become deeper and quicker. As the clot dissolves then blood flows back into the part of the lungs that had the blockage and your breathing and pain should improve. Most people with pulmonary embolisms will make a full recovery but a small percentage will be left with some lung or heart damage. What treatment is offered for pulmonary embolism? Medication (called anticoagulants) will stop the blood clot getting larger, and prevent new blood clots forming. Your body, on its own, will break down the blood clot that has already formed. This process usually takes between 4 and 6 weeks. Anticoagulant treatment comes in various forms including: Injections Warfarin tablets Rivaroxaban tablets Your doctor or nurse will discuss with you which one is suitable for you. You will be given an anticoagulation alert card for whichever treatment is used, and you should carry this with you at all times. page 3 of 8

4 Why did I have a pulmonary embolism? Pulmonary embolisms can be split into two categories: Provoked Non-provoked As the name suggests provoked pulmonary embolisms usually have an obvious cause. Causes for pulmonary embolisms may include: Surgery Illness Long haul flights Contraceptive pill A period of inactivity such as a hospital stay, pregnancy, obesity An injury to the legs or arms. These types of pulmonary embolism account for around 50% of cases. Non-provoked pulmonary embolisms do not necessarily have an obvious cause. We know that as people get older they are more likely to suffer from blood clots and some people may have conditions of the blood that increase their likelihood of developing clots. For a significant number of people, however, it is impossible to say exactly why they have developed a clot. Is there a link between pulmonary embolism and cancer? In a small number of cases pulmonary embolism can be associated with cancer. Some types of cancer can make the blood more likely to clot. If your pulmonary embolism was non provoked we will do certain investigations to try and rule out any cancer. These include blood tests to check your liver, kidneys and blood cells and sometimes x-rays and scans. Your nurse or doctor will talk to you about any risk factors you have and the need for any further tests. page 4 of 8

5 What should I expect when I go home? It is not unusual to experience mild pain in the ribs or back after a pulmonary embolism. This is often simply the clot beginning to dissolve. Patients often feel quite tired when they return home as they start doing a bit more for themselves; this is usual and will improve with time. Is there anything I should look out for when I go home? If you develop severe central chest pain or severe breathlessness you should seek immediate medical attention by returning to the A&E Department. Who should I contact if I have any concerns? Your family doctor will be informed of your pulmonary embolism, and the treatment you are receiving, soon after you go home. You should contact them if you have non-urgent concerns. For questions about your treatment during working hours, speak with your family doctor or call the VTE nurse in the Anticoagulation Clinic at the Royal Hallamshire Hospital on In the event that you are worried about new symptoms or problems with your treatment, you should seek medical advice urgently. In the event of serious new symptoms, call an ambulance. When can I return to usual activities and work? Safe daily activity levels depend very much on how you feel and the size of your clot. As a general rule activity should be increased very gradually over the first four weeks after diagnosis of a pulmonary embolism. You should be guided by breathlessness and stop to rest if you feel chest tightness or lightheaded. page 5 of 8

6 You should avoid bending over or carrying anything heavy, particularly if there was any evidence of heart strain when your pulmonary embolism was diagnosed. If your work is physically strenuous you should build very slowly back up to your previous activity levels. If you have any concerns or questions please discuss these with your nurse or doctor. Is it safe to travel? We advise against air travel in the first month after being diagnosed with a pumonary embolism. Longer term there is no reason why you should not be able to fly safely again. General rules would be to make sure you get up and walk every hour on the plane. Try to book an aisle seat, avoid alcohol and drink plenty of water. You may need to inform your insurance company that you have had a pulmonary embolism. Car and train travel can be undertaken as usual but we recommend regular stops (every 2 hours) for a short walk. When will I get a follow up appointment? Most people who have a pulmonary embolism will be followed up at a 3 to 4 month out-patient appointment. This may seem like a long time to wait for an appointment, but it is important that the medication given to you has time to work. You will be seen in clinic by a respiratory doctor and a haematologist (expert in blood) and if you are still having any residual problems these can be discussed then. It is not usual practice to re-scan patients who have had a pulmonary embolism if breathing and pain have improved, as it is likely that the clot will almost certainly have gone. page 6 of 8

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8 Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit Registered Charity No Alternative formats can be available on request. Please Sheffield Teaching Hospitals NHS Foundation Trust 2018 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. PD8000-PIL3349 v3 Issue Date: November Review Date: November 2019