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A massive pulmonary embolism refers to a blockage in an artery of the lung, either the primary artery or one of its branches. The object that is blocking the artery is referred to as an embolus, and it obstructs blood flow to the lungs and eventually the heart. A massive pulmonary embolism is a blockage of 50% or more in the artery. Pulmonary embolisms of any kind can be fatal.
Unfortunately a common occurrence in cancer patients, bedridden patients and other people with complications, a massive pulmonary embolism has the potential to occur in even healthy adults. Most people who are killed by pulmonary embolisms die within the first few hours of the event, making treatment especially time-critical. The problem is that early symptoms can be commonly mistaken for other simple ailments, and they often go undiagnosed.
In most cases, a pulmonary embolism is caused by a blood clot that originates in the legs and travels through the arteries to the lung. This is called venous thromboembolism, since a thrombus is a blood clot. In rarer cases, the embolus is made of air, fat or amniotic fluid. Either way, the embolus blocks the flow of blood which can result in collapse, very low blood pressure and even death.
Symptoms of a massive pulmonary embolism are difficulty breathing and heart palpitations. These early symptoms are often overlooked because they are not severe. Clinical signs of a pulmonary embolism are a rapid heart rate and/or breathing, as well as low blood oxygen saturation. Cyanosis is a major warning sign of a pulmonary embolism in which the fingertips and lips begin to turn blue.
A doctor will often run tests to rule out pulmonary embolisms in patients. He or she may order a CTPA, which stands for computed tomography pulmonary angiogram. This is a medical diagnostic test which takes an image of the pulmonary arteries. The doctor can then see if there is any blockage evident. A blood test which can also be administered is called a d-Dimer test, and it looks for protein fragments that are left after a blood clot has dissolved.
Treatment of a massive pulmonary embolism can require surgery in very severe cases. This is called a pulmonary thrombectomy, and it is an emergency surgery to remove blood clots from the pulmonary arteries. If the condition is not deemed to be life-threatening, typically blood-thinning drugs will be prescribed, like the anticoagulants warfarin and heparin.