Chris Bosh of the Miami Heat was recently diagnosed with a pulmonary embolism (PE).
A pulmonary embolism is a fragment of material, usually a blood clot that travels from another part of the body (typically a thrombus of the deep veins of the legs) to lodge in a segment of the lung,
Pulmonary embolism is a fairly common condition affecting close to 500,000 people a year in the U.S., resulting in close to 100,000 deaths according to the American College of Chest Physicians.
Deep vein thrombosis (DVT) tends to form during periods of prolonged inactivity such as long plane or car ride, or when the person is immobile in bed.
Other conditions with a heightened risk of DVT and PE include orthopedic surgeries (knee and hip replacements) being overweight, certain cancers and use of birth control pills while smoking. Less common causes of PE include fat fragments from fractures or surgical procedures (fat embolization) and air bubbles.
Symptoms may include cramping and/or swelling of a calf, leg or arm area involved, or may not have any localized discomfort at all. Instead,
a discomfort may occur, such as shortness of breath, dry or blood-tinged cough, weariness from physical activity or a chest pain, sometimes worse on inspiration (drawing air into the lungs). A fast pulse and lightheadedness can also occur.
A pulmonary embolism can be life threatening and in rare occasions when the clot size is large enough to affect a main airway, can result in sudden death. In addition, a DVT can cause a stroke if the blood supply to the brain is affected.
Acute treatment may call for clot busting drugs (thrombolytics) similar to those used in acute heart attacks when an umbrella-like device called an IVC filter is placed in the inferior vena cava (a large vein in the abdomen) to decrease the risk of large clots travelling from the legs upwards towards vital organs.
Long-term treatment of several months will also consist of oral anti-coagulants-(blood thinners). Interestingly enough, anticoagulation does not dissolve clots, but can prevent formation of new ones, allowing the body’s own thrombolytic or anti-clot system to dissolve the embolism.
Jorge Bordenave, M.D., an integrative cardiologist in Coral Gables, is also an Assistant Professor of Medicine at FIU and Nova S. E. University and an Adjunct Professor of Medicine at Des Moines University. Certified by NOAA, UHMS as a dive/hyperbaric medicine physician, he can be reached at 305-446-2444.
