A person who has been diagnosed with a pulmonary embolism has a clot in one of the large vessels of the lungs. This clot normally travels to the lungs from another area of the body, such as from the legs. Clots can develop in the deep veins of the legs for a variety of reasons, and this is known as deep vein thrombosis, or DVT. In order for a person to be properly diagnosed with a pulmonary embolism, he or she will need to have a series of tests. Sometimes, not enough testing is performed, which leads to an incorrect diagnosis. Delayed or incorrect diagnosis of pulmonary embolism can lead to improper treatment or death.
When a person develops a pulmonary embolism, he or she will have shortness of breath or difficulty breathing, a feeling of his or her heart beating hard in his or her chest and possibly chest pain. Other symptoms include a low oxygen saturation percentage, cyanosis, particularly seen around the mouth and fingernails and tachypnea with tachycardia. The blockage in the lung ceases the flow of blood back into the heart muscle. This puts pressure on the right ventricle of the heart, which is the cause for the symptoms. When a pulmonary embolism is not diagnosed in time, a person will most likely suffer from atelectasis, hypotension and possibly death. Those who are at an increased risk of developing a pulmonary embolism are cancer patients, people on complete bed rest and those with sedentary lifestyles.
How is Pulmonary Embolism Diagnosed?
There are several medical tests and examinations that can be done to properly diagnose a pulmonary embolism. Some of the most common tests are:
- X-ray of the chest
- Arterial blood gases
- EKG – to rule out myocardial infarction
- CT of the chest
- Ultrasound – to locate the clot
- Pulmonary angiogram
- V/Q ratio radionuclide lung scan
- Venous ultrasound of the leg veins – to detect other clots
Patients may or may not be hospitalized for a pulmonary embolism. Most often, patients may be placed in the hospital for a few days, to get started on blood thinners. As the condition can be very painful, pain medications are given, along with oxygen to assist the injured lung in perfusing oxygen. Patients who are experiencing severe effects from the clot, or have a clot that is not responding to heparin, may need to undergo surgical excision of the clot.
Common Misdiagnoses of Pulmonary Embolism
Because a pulmonary embolism can mirror other illnesses on the initial examination, it is possible for this condition to be misdiagnosed. A pulmonary embolism is most often mistaken for a myocardial infarction, pneumonia, congestive heart failure, pericarditis and even pleuritis. Improper diagnosis can lead to incorrect treatment and delay of proper treatment.