You may have heard about the term pulmonary embolism (PE). It is a life-threatening condition in which the blood vessels in your lungs get lodged with blood clots. PE is categorized into different types depending on the size and position of the blood clot. One of these types is Saddle Pulmonary Embolism which needs urgent medical attention. It can result in breathing problems and with no proper treatment, leading to death. For optimum prevention, you must have a deep understanding of the causes, risks, symptoms, and types of saddle pulmonary embolism.
Let’s get to know all about saddle pulmonary embolism.
About Saddle Pulmonary Embolism
Saddle pulmonary embolism (PE) is one of the rarest forms of acute PE, making 2.6–5.4% of all cases. Saddle pulmonary embolism happens when a huge blood clot gets stuck at your main pulmonary artery intersection. It impacts the branches reaching the left and right lungs, carrying deoxygenated blood from the heart to the lungs. This blockage can obstruct blood flow to both lungs, impeding blood pressure. Moreover, the blood that reaches the lungs won’t get reoxygenated, causing damage to crucial organs like the brain or kidney.
If not promptly treated, saddle PE can make your heart stop working, leading to sudden death. Urgent medical care is crucial to address this condition effectively.
Risk Factors
Blood clotting is a very essential process for the human body, helping to seal wounds and avoid excessive bleeding. Once your body is healed, the body gradually breaks down those clots, absorbing them back into the blood flow.
Nevertheless, complications can arise when blood clots form without any injury or fail to dissolve properly within the bloodstream. The primary cause of pulmonary embolism (PE) is said to be deep vein thrombosis (DVT). It is the condition where blood clot starts originating in the deep veins of the arms, legs, or pelvis.
While blood clots can affect anyone, it is worth noting that men are generally more prone to facing PE than women. Various factors can contribute to an increased risk of developing blood clots, some of which include the following:
Increased Estrogen
When your hormone estrogen is high, there is a high chance of blood clotting. Reasons for estrogen level rise can be:
- Pregnancy; with blood clotting risk up to five times
- Childbirth; particularly the first six weeks of delivery
- Hormone or contraceptive medications
- Testosterone replacement process
Weakened Blood Flow
If you have weak blood flow, there will be an excessive amount of blood in the vessels, resulting in clots. Some of the reasons for reduced blood flow are:
- Trauma, Coma, or long period of bed rest
- Driving or flying for more than 6 hours without stopping
- Paralysis
- Wearing a cast after injury
Vein Injuries
When a vein sustains an injury, it triggers the formation of a blood clot within that particular vein. If the body fails to effectively dissolve and reabsorb the blood clot, it can impede the normal flow of blood. Moreover, it can potentially dislodge and migrate to other areas of the body. Various factors that could contribute to vein injury include:
- Fractures
- Muscle injury
- Surgery
Chronic Medical Conditions
A person is most likely to develop saddle pulmonary embolism if they are previously suffering from a chronic medical condition. Some of the following conditions have a high risk of developing clots:
- Lung diseases
- Heart diseases
- Cancer
- Bowel issues
Other Factors
Many other aspects may lead a person to develop saddle PE. They include:
- Smoking
- Age factor; people above 60 have more chances
- People with or inherited blood clotting disorder
- People needing blood thinners
- Obesity
- Varicose veins
Symptoms
Saddle Pulmonary embolism manifests with a distinctive set of symptoms that indicate its presence within the body. These symptoms can vary from person to person but often include:
- Sudden shortness of breath, even during rest or minimal exertion.
- Sharp or stabbing chest pain that worsens with deep breaths or coughing.
- Rapid or irregular heartbeat, accompanied by palpitations.
- Unexplained cough, sometimes accompanied by bloody or pinkish sputum.
- Excessive sweating, accompanied by a feeling of anxiety or impending doom.
- Sudden lightheadedness or dizziness, potentially leading to fainting.
- Pain or swelling in the legs, usually accompanied by redness or warmth.
- Blue-tinted lips or nails indicate a lack of oxygen in the bloodstream.
Different Treatments for Saddle PE
Urgent medical intervention is imperative for individuals diagnosed with saddle pulmonary embolism (PE), and hospital admission to an intensive care unit may be necessary.
The primary objective of treatment is twofold: to dissolve the existing blood clot and restore proper blood flow to the lungs, while simultaneously preventing the formation of new clots. Here are the key treatment options available:
Medications
There are various medications available to address the condition of saddle pulmonary embolism (PE) and its associated risks. These medicines play a vital role in managing and treating PE by targeting different aspects of the condition. Here are some medications mainly recommended by specialists:
- Anticoagulants: These medications, often referred to as blood thinners, work to prevent the formation of new blood clots. They help maintain proper blood flow and reduce the risk of clot recurrence.
- Thrombolytics: Also known as clot-busting drugs, thrombolytics are administered in severe cases of PE to rapidly dissolve the blood clot. They act swiftly to restore blood flow and alleviate symptoms, but they are generally reserved for critical situations.
- Antithrombotics: These medications inhibit the formation of blood clots by targeting specific clotting factors or platelets. They help prevent new clots from forming and reduce the risk of complications associated with PE.
Procedures
Here are the general procedures that are commonly followed during PE treatment:
Diagnosis: PE is diagnosed through a combination of medical history evaluation, physical examination, and diagnostic tests. These tests may include blood tests, imaging studies, and sometimes invasive procedures like pulmonary angiography.
Stabilization: Immediate medical attention is provided to stabilize the patient’s condition. This may involve oxygen therapy to ensure proper oxygenation, intravenous fluids to maintain hydration and pain management.
Inferior vena cava (IVC) filter placement: In certain situations, when anticoagulants are contraindicated or ineffective, a small filter may be inserted into the inferior vena cava. It is inserted in the main vein returning blood from the lower body to the heart to trap clots.
Percutaneous thrombectomy: In specific situations where the clot burden is extensive or causing severe symptoms, a percutaneous thrombectomy procedure may be considered. This minimally invasive technique involves using specialized tools to physically remove or break up the blood clot from the pulmonary arteries.
Summing up
Saddle pulmonary embolism (PE) poses a grave risk, potentially leading to life-threatening complications. Shockingly, approximately 1 in 4 individuals who develop any type of pulmonary embolism experience immediate death. Furthermore, an additional 10-30% succumb to the condition within a month of diagnosis.
Receiving prompt medical treatment within the crucial first few hours after the blockage occurs can significantly impact a person’s prognosis. Early detection, coupled with urgent medical care, plays a vital role in reducing mortality rates with better chances of recovery. Visiting a specialized sleep disorder center can help address your concerns comprehensively and provide appropriate diagnosis and treatment options.
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