Pulmonary Embolism
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- Опубликовано: 8 июн 2024
- Pulmonary embolism (PE) is a common but very serious medical emergency that everyone should be aware of. In simplistic terms, a pulmonary embolism can be thought of as a ‘Lung attack’. In a heart attack, there is disruption of the blood supply which leads to cells of the heart dying. With a PE, there is disruption of the blood supply to the lungs leading to death of lung cells.
Blood is delivered to the lungs by the right heart which pumps blood into the pulmonary arteries which divide and subdivide and perfuse all the lungs. Here the blood collects oxygen and the then travels to the left heart where that oxygen rich blood is pumped to the brain and the rest of the body.
If a blood clot gets into the pulmonary arteries then it will block the passage of blood into the lungs and that part of the lung will die. In addition, there will be a sudden and significant reduction of the amount of oxygen collected by the blood and therefore there will be a profound drop in oxygen levels within the body. There will also be a significant reduction in the amount of blood getting into the left heart and this will cause the amount of blood going out of the left heart to drop markedly which can cause heamodynamic collapse and even death.
By far and away the commonest mechanism for PE is the development of blood clots in the legs (termed DVT) which then travel into the right heart, up to the lung and cause the PE in the lung. PE can also result from fat, air and cancer cells causing a blockage in the pulmonary vasculature.
How common is it?
The incidence is anywhere between 40-115 people per 10000 per year for PE and 50-160 people per 100000 per year for DVT.
The incidence is higher in men compared to women and in the US it is estimated that 100000 people die every year of a PE. This is likely to be an underestimate because when someone drops down dead suddenly, it is often assumed that the patient has died of a heart attack and a detailed autopsy may. Not be undertaken. It is likely that a bunch of these patients could have died due to a pulmonary embolism. A timely diagnosis is crucial because without treatment, up to 30% of patients will die but if timely treatment is delivered then that number drops to 8%.
We love you, and appreciate you very much, so please never apologize for anything! You are a gift to humanity. Thanks for all that you do.
Is this THE Julie, Sanjay? 😡
@@peggymicsky8607 Given your emoji choice, I sure hope I’m not THE Julie! 😬 Just an appreciative fan of the good doctor.
The face was for him, not you! You're just another banana!
You literally woke me up from the rotten medical care system in the US.
I had pain all over my body and I was “diagnosed” with fibromyalgia…. It was Lyme disease. Then, I started working out again, quit smoking, start a VERY healthy diet and got into the best shape of my life …. Until Halloween of 2018 that I felt like a sword was in my back …. It was a blood clot on my lungs. 😩
6 months of blood thinners and off birth control at the age of 36. That was horrible! Love you 😍 and your channel !
Get your vitamin d level up to mid range, less chance of clotting, plus remove Omega 6 foods and increase Omega 3 foods, check homocysteine levels, take b vitamin complex, B6, B12, B9 most important.
Many foods have anti coagulant effects.
Have you had a genetic test for factor 5 Leiden?
Clots don't break down as fast with that.
I ve been dealing with Cardiophobia for 8 years now, including the fear of PE which might cause clotting either in the lungs or heart, i also know someone who died of PE in their sleep, which does not make it easier...
But I really enjoy your video because they give me very "neutral" information about the topic and help me rationalize my anxiety.
I actually made a big step forward in my life simply because i watched one of your videos years ago, it was about heart disease, and you were simply stating things like "If you have heart/cardiovascular symptoms while resting but NOT while you are exercising, then you either have one the rarest heart defects or you dont have any".
Also if you can increase the level of pain by touching/pressure its not coming from the heart and things like that.
Believe or not but ive been to many doctors and they did not give me simple advice or explanations like that.
Back then i basically forced myself to do BRUTAL workouts (which is was afraid to do before because of my anxiety to exercise at all), because you basically told me im fine, because i did not have ANY symptoms while exercising and im a big believer in probability, so i dont not automatically assume I have a rare disease (and doing workouts would lower my health risks anyway).
I survived (obviously) and was SO impressed of what i can actually do (these workouts were brutal!) while not having any troubles at all, i was super out of shape but could still do so much (I do not smoke/drink/coffee/drugs).
This has given me a lot of security in my life, I basically train nowadays just to fight back my anxiety, because it shows me everytime than im fine and functioning.
I would not have gotten to this point without one of your videos, to me the best weapon against anxiety always was rationality, so thank you for giving me a little bit of that!
Still a way to go, but still your videos definitely helped me, so thanks!
Also, very nice shirt! 😊
Your anxiety is preventing you from living. I know because I had a doctor screw up and I ended up in a cardiac unit. Panic attacks for 2 years. Push thru and live your life, it was like I was a zombie I know just think when God takes me it's alright. This is how I started watching his videos to learn how to live without fear through his knowledge.
@@jeffreybaier5312 you are lucky to overcome your fear! I Have been an ICU nurse for 45 years in a very well known medical center in CA and just retired! Spending every minute about getting sick and worrying about my hypertension, heart attack and stroke!
I realize it’s my fear is actually going to kill me but just unable to stop the fear and anxiety! 🥲
@@anibabikian Wish I could help you but I'm no medical expert. Can only say, try listening to soothing music, e.g. sounds of water, these I find most comforting and relaxing.
I have atrial fibrillation but cannot take anti-coagulants because I have haemorrhoids that can bleed heavily at times. So I take Magnesium Taurate that assists my Afib and pray and push the thoughts of having a stroke as far away as possible.
Take care and all the best.
@@anibabikian I understand and the other doctor wanted to dope me up to handle the anxiety, I refused to take it. I still have the full bottle on the shelf. I want you to try Chinese medicine, Acupuncture, Acupressure and herbs might help you. I know I was in a car accident and suffered from migraines for years. Please give it a try, it's will help. Usually not covered by insurance but your health is all that matters. God be with you.
@@jeffreybaier5312 thank you so much!
I have not used The anti anxiety meds either!
I m not so worried about the anxiety itself but about it raising my BP so much! Have been an athlete all my life and had a very tough life, but seeing my BP so high makes me have the worst panic attacks. Working in ICU as a registered nurse for 22 years has made things worse!
Just retired and it feels scary!
Will try Accupuncture!
Thank you so much
Had one of these years ago after my daughter was born. It was the worst. I was at work taking care of my patients and I felt like I had been running all day. I couldn't breathe at all. The sad part was waiting to be seen in the ED. I waited 8 hours and got progressively worse. I understand people fib sometimes to get seen faster, but I wasn't. I had to stay in hospital on heparin therapy for many days. I lost my job but I was happy to be alive
How far did you recover?
8 hours is totally unacceptable.
Did you have any other symptoms?
Did they check your oxygen levels in those eight hours?
The American health system model is corrupt and needs a change.
I liked the last line of your conversation !..... Very positive approach !!
You lost your job???!?!?!!?!?!???
70 years old and feel a lot safer receiving information like this from you. Also myself being in the southern part of the US. I really like your shirt.
Dr.York! You are a blessing to me. You have comforted me about AFIB when my health care people are not giving any worthwhile information. I am grateful for someone who shares medical information with intelligence and respect for the patients ability to consume and discern the data shared. I thank you.
Yes i diagnose an afib also long time ago like 2 decades now. I was so stressed out in my job and i used to live in high desert thats high elevation. I left high desert and move atleast 1000ft below sea level and my afib is gone. When i come across dr york i feel so confident that my afib came from my GERD when he discussed that coz when i got hospitalized the acid came up from my mouth but other doctor wont listen to me. I knew there is something to do with my gerd with my afib. Thanks to Dr.Gupta!! Ur the best.
I know one man who died of PE because his doctor treated it like a common cold instead of sending him to the ER. The irony is that this was not the man's first experience with PE but he trusted his doctor too much. I also noticed that doctors are much more reluctant to palpate and make physical contact with patients as in the old days; they just prefer to type away and look at screens, order tests, look at screens, rinse repeat. They look distracted and don't really look at the patient unless they are passed out. Has technology reduced doctors actively engaging with patients before them? This hands off approach makes me think ChatGPT will take over most hospital care unless the patient is code blue, then they throw you in the auto-doc conveyor belt, kind of like a car wash and robotic arms do the rest. You come out the other end with a blanket or in a box.
You are the absolute best!!!! Old ICU nurses would not say that easily to doctors but I totally mean it! Respect!!!!!
Missed you from LA!
Thank you -- you've gathered together a very useful and detailed explanation -- so grateful.
Wow I've just found your channel! I'm training to be a community first responder. This kind of video is like striking gold. I've shared it with my fellow trainees.
A good friend died of a PE within an hour of experiencing sharp and unbearable chest pain. She was supposed to outlive us all. So this video and I'm sure your others will be incredibly helpful for many of us out here. Thank you and keep up your sterling work!
Thank you very much for this video.
Great job.
Shared with a friends who got PE a few month ago.
Welcome back Dr Gupta. I always look forward to viewing your amazingly informative videos. By the way, that is an awesome looking shirt you're wearing. Las Vegas USA says hello.
Thanks, Doc!
thank you so much for all your wonderful information. You have helped me so much!!!!!
Really good information. I enjoy all of your videos and the information you provide. Thank you
Thank you for sharing!
Thanks for everything you do, Dr.Gupta
Appreciate you Dr. Gupta
Very educational, thank you Boss 👍👍👍
So good to see you.
Excellent video again
Tough topic well covered. Well done
Doc, great to see you, I advise many people to your site. Thanks for all you do.😊
Thank you, Dr. Gupta, for this thorough explanation of PE: symptoms, diagnosis, and treatment.
Well explained, and helpful to me today!! Thank you, Doctor Gupta.
Thanks G gupta nice vedivo about PE informative
Hello you are our hero baby you help take away our pain thank you big respect for all your talks and help peace and love
Very interesting, informative and slightly scary! Thank you.
Excellent advice brother ❤️
Your videos are an incredible delight to me dr Sanjay- as a retired clinician I so welcome the continued educational content and the wonderful way in which you impart knowledge at the optimum level. My thirst for knowledge is un diminished . Thank you so much and look after yourself too!
Missed you Dr Gupta. Hope you enjoyed Kenya.
Thanks Dr. Gupta,
Had a DVT and PE after ankle surgery 14 years ago. Retired and keep very active. On warfarin, it does the job and no one has given reason enough to change to Eliquis.
Eliquis is a bit better for internal bleeding but very, very expensive for the average person. Many older patients are living on a fixed income. Doctors are usually wealthy and I'm not sure they understand income restraints.
Many drugs not just birth control, patients should be told of possible side effects before starting any drugs. (but rarely they are told)
it's like i'm in a classroom,listening to a lecture of the best professor in a medical school. thanks dr gupta. if you could tackle a topic about Alpha Talasemia, i would be very enlightened about it, my 30 yr old daughter has this.🥰
Love the information. Shirt is 😎👍
I had this problem too one time. The ER wanted me to stay and be treated but I talked them out of it because I didn't have a housesitter and was targeted for surveillance burglaries. The ER gave me heparin shots (SubQ: abdomen) to give myself every day at home and that seemed to solve that issue. Thankfully those injections saved me a hospital stay and more burglaries at home.
Thanks Dr.Gupta for all your help and info.
Hi Doctor Sanjay,
The first time I became aware of your website was when I saw "high blood pressure and the white coat syndrome"...I related to that. It's always been a problem for me. Your comments helped to relax me so much.
Unfortunately, since moving to a new "doctor's surgery"..it seems the "left hand " ..does not know what the "right hand" is doing and I'm getting mixed messages from different people I see! it's so frustrating.
Anyway, apart from that. I've read some of the posts to you. Just saying...love to Bluebelle. She reminds me of my mum's dog...a Lhasa Apso. We found him at Battersea...a dear Boy we called Mister Jones.
The best
I Thank God for my cardiologist because when my husband took off his insurance l couldn't fill my prescription for Eliquis so l had to go to the hospital to make sure l didn't have a clot. But Praise God l am fine now just need to lose weight.
Brilliant DOC G. Also from what I understand blood clots can be caused by glycation ( excess sugar in the blood) I don't know if this is correct. Also TRT therapy.
Do you recommend calcium scale scanning and what are the side effects of the scan?
Can you please do a video on TMI
Activ-6 trial on using IVM during COVID, 5x less PE in the IVM group.
Not what they were looking at but it's there.
Can you make videos about hyper dynamic ejection fraction
Hello, dr Gupta! I occasionally get an increase in ectopics when going from a supine position to standing. They happen more frequently at night if I get up to use the loo. They really scare me, I’ve had an ecg and highly sensitive troponin test and nothing showed anything abnormal or worrisome but they also didn’t catch any ectopics. I’m wondering if there is a reason for this happening when changing posture? Could you enlighten me? Many thanks
Thank you for this video. How dangerous is peripheral thrombophlebitis?
Nothing like a PE but I would guess you could use a change in diet, if one part of your body is showing problems it couldn't hurt to clean things up before something else pops up.
My 66yr old brother died suddenly about 6 weeks after hip replacement. He seemed to be doing well. No autopsy so I wonder if he possibly had an embolism?
Doctor pls do a video on insomnia 🙏
And a lot of these pulmonary embolisms are the direct result of the jib jab that you were pushing six months or so ago
Yes, you’re right! I got a pulmonary embolism (5 pulmonary embolism) on my lungs after the first & only jab! 40 minutes after I got it.
My 75yo brother had one. He's got barrettes esophagus also. He's been a heavy drinker of alcohol all his adult life
Doctor in this Era of diseases how can we live. So much fear everywhere. Omg.
Live it to the fullest until you are called home, that's it.
People take their health for granted until a health crisis occurs.
@@RichRich1955 do not you feel it is health scare system rather than health care system
@@jeffreybaier5312 trying to do that but ....
I had a Kaiser Permanente doctor od me and I ended up in a cardiac unit at WellStar in Atlanta. I was a level 5, I said to the nurse so I should get ready to meet Jesus. Kaiser doesn't even have an ER. I had a cardiologist check my heart for damage, luckily I survived and he said that doctor screwed up. They have arbitration you can't sue. I've followed Dr. Gupta to learn how to trust my heart again. Just be careful.
I had one in march 2020. Following a ovarian cyst laparoscopy. I suddenly realised I was really short of breath. Then I coughed up blood. Many clots and pneumonia in right lung. Then developed pots and mcas after that
Thanks Doc Gupta i always watch your videos.. my mother passed away 2021 she had a pulmonary embolism she had when she flew from Philippines to US. Her cardiologist Doc said she should walk around in the plane coz of the high elevation. TheThis is back 6-7yrs ago. RIP mom 😔 doc my question is this inherit? I inherit my parents hypertenstion my dad had hart bypass at age of 62 now his 83 and still alive thank god. Doc my quesrion is there any posibilities to get a blood clot if you have a varicose veins ? I heard your prone in blood clots if u have varicose veins my mom has it and I inherited her hypertension and varicose veins. Im taking eliquis and losartan also atorvastatin. Im exercising aand watching i ate. Also i lost 10lbs in a wk coz im
Over weight.
Had a chest xray today, heart rate going up and down from 116 down to 40 and has been doing so for a while. Get a sharp pain occasionally when breathing but no where near as bad as when I had pleurisy. I'm 54 and have zero energy and zero exercise since I had covid over Christmas 2021, currently waiting for an appointment at cardiology, god knows how long that will be.
You will get better.
Move your microphone closer to you. I have my phone turned up at max and I can barely hear you.
In 2020. I had severe chest pain. Finally my wife convinced me to go to the hospital. It got to the point where it was screaming. Pain felt like a dagger going into my lungs. Every time I try to take a breath it was excruciating pain. It was one of the most painful things I've ever felt turned out. I had a pulmonary embolism COVID-19 and pneumonia all at once several weeks prior I had knee surgery I believe the surgery could've been the cause of the pulmonary embolism possibly COVID-19 as well. Might've caught it at the hospital.
Thanks so much sir for the video. I think I also have a PE (since Wells score is 7, signs of DVT there, COVID +ve) but I cannot do a CTPA scan right away because in the last year already I had 2 HRCT scans. I am being treated at home with DOAC (Xarelto 20mg OD). But, problem is mera SpO2 level persistently below 95 aa raha h...90 % 89% nearly aur during walking 80 % its coming and repeated syncope (BP at rest 105/60 mmHg, normally I am patient of hypertension). Abhi kya CTPA karne ka zarurat hai ya iss treatment me gradually PE resolve ho jayega? I am very afraid of radiation exposure from CT. Plz help sir...I am from ur country India only....I am just 17 years and Medical aspirant (NEET UG 24). I am really afraid with this PE
Thank you Dr. For this information. Have you ever seen a d dimer of 22000 but the patient didn't have PE after CTA was done? What other factors that can cause this high number?
There could be a clot/ clots anywhere in the body with that High a D-Dimer reading. Hope the patient is doing fine now.
Other factors can also cause high d-dimer. For example: pneumonia, sepsis, etc. Also it can be elevated if clots are there in other parts of body like MI, CVA, DVT, etc.
Hi Dr Gupta, can you please make a video on low blood pressure. Minor but consistent WPW delta wave and blood pressure that stays low like 85/55 but becomes better with a bit of walking. Problems with fatigue exhaustion etc. Another weird issue is that when this person stands up, it is manageable but after standing still for like 30 to 40 min at the same place, becomes so lightheaded that she collapses on the floor safely. No doctor can figure out any problems and cardiologists think it’s not caused by the heart. What do you think?
I too would like video on low BP I have gone from high BP on medication to 79/47 took off medication and sitting around 85/55 to, I also have Bradycardia and I am same with extreme fatigue/exhaustion and near fainting, lightheaded. I have been like this 7 years and still no answers
Doc is covid infected like me if prone in blood clots ?
What about unprovoked DVT’s; should they be on life long anticoagulants ? Or could they simply self medicate with 75mg aspirin daily ?
Hello Dr Gupata I have been trying to contact you for ages , but in vain . Pls Dr Sanjay you are so very busy, I understand pls do let me know how to get in touch with you. Take care Dr Gupata
❤
I'm on Xarelto because I have atrial fibrillation. I'm considerably overweight, have congestive heart failure and also I don't have any cartilage left in my knees so I can't move around that much and I do lay down a lot, but everytime I get up which is like every couple of hours, I do leg exercises. I've also started to exercise regularly every day. Even when I get up in the middle of the night to use the bathroom, before I lay back down, I do leg exercises.
Given the information here that I just gave about myself, will that help in preventive measures?
Check out the Dr. Jason Fung channel for weight loss.
The knees can also be helped with diet and light.
A doctor from NASA working with astronauts becoming weaker in weightlessness said standing up every 20 minutes even without exercise can help with recovery.
The body laying flat deteriorates, it's like being weightless, we need to routinely have our bodies fight gravity to maintain our systems.
So what does someone with so much knowledge about Cardiology, do to keep themselves healthy?
Hello Dr Sanjay, I really appreciate your work. The Content is super amazing and very informative. However, you seem to be inconsistent in the content post and Video editing. I know you're swamped with work and have busy days. So for these reasons, I want to be part of this journey and would like to assist you in all aspects of social media growth from editing to creativity. My experience will surely save days-hours of time and effort. Please let me know when you are available to discuss this.
Yes, you are right Saurabh. I could definitely do with some help. Pleas email me at yorkcardiology @gmail.com and we can hav a chat
Hi, my LDL cholesterol, is 220, I think is 170 now, is that bad?, what can I do?
Check out motivational and Dr. Eric Berg on RUclips. You can also Google how to lower cholesterol. Alot of it is what you eat.
Dear Dr Gupta,
I live in New Jersey and there are a number of excellent physicians. But I was recently told there is nothing that can be done 😢 for my situation. In 2021 due to most vertebra w/ compression fractures (osteoporosis) I had all thoracic cement augmentation. Unfortunately T6 exploded and bilateral pulmonary emboli were found by CT. There is extravasation of vertebral plastic material into the anterior pre vertebral space which extends anteriorly into the mediasrinum toward the superior vena cava and is likely within a venous tributary. There is a linear foci of hyperdensity in the region of the left pulmonary vein at the hila and within a left lowe lobe basal lateral segmrntal pulmonary vein.
My doctors are great but they will not give me prognosis. Like, in you video just now you indicated a sensation of fainting. They gave me nothing to work with, meaning what to watch out for, like I have to ask the questions, they just answer - such as if I went running and my heart was blasting away in good way, could I dislodge a cement emboli.
I searched patient comments and they simply said get your house in order. I'm 69 yrs young.
Do you know of any good treatment research articles or just information in peer review literature I might glean some alternative tx? They say it is like shrapnel - let it alone. I don't accept that. It is like giving up. I love this life , this world, universe and all. I am so humbled by the elaborate system of healing and resources... hospitals, accademic medical centers Dr's offices, youtube, friends and family with bits of info or encouragement. How God has put the desire to heal each other in us. It is so bitter yet so sweet when the University Hospital helicopter take off past our window. Off they go. The amount of effort, resources, and $ that goes into it all.
You know, people suggest a law suit against the interventional radiologist that blew the bone. No. He's a rock star to me. Pre-kyphoplasty I was bowel and urinary incontinent. I would bring my pillow in the ambulance to shreek bloody murder into because my back pain was 100 out of 10 so that the hospital could release an upper colon impaction (peristalsis affected by nerves crushed by thoracic vertebral compression)... etc. Things (pain , QOL) are better now than before procedure. Every bone in every body is different. That thoracic bone was weaker and it blew. I have mercy on the doctor and feel bad that it went that way. I just want to know the brutal truth about what to expect from the bilateral pulmonary emboli.
I re-read the pulmonary CT w/contrast and it indicates I not only have multiple bilateral pulmonary cement emboli, they also indicate that I have many small non-cement PE, esp on/ ligula. If I take a blood thinner or med to discover clots, I read case study where this released the botched kyphoplasty pulmonary emboli and it/they lodged in worse vessels and patient died. Is there a specialist in the Brick/Toms River New Jersey area that specializes in this sort of post kyphoplasty complication that would be able to review my case? My primary insurance is Medicare with Humana Supplemental. I've had 3 doctors tell me this is by far the worst kyphoplasty serious adverse event they have ever seen. I need help. I am starting to hock up foul smelling sputum, smells like road kill. I have a Follow-Up w/pulmonary at the end of Oct and that is a month away from this writing.
Correction above : not "discover" clots but "dissolve" clots...
my mum survived a blood clot passing through her heart in December. She is 56. The doctors have let her down for a long time... but she is having surgery soon. People need to be educated about this, especially post Covid. She had a blood clot earlier in her life and was lucky she knew how it felt, they did not even believe her in A&E but gave her the blood thinning injection anyway. They later said she was right. We know our bodies better than the doctors and they keep telling me that my problems are anxiety, and I know they are not. They are likely hereditary and I have a weakness somewhere as my mum does. Thank you for educating people on this important subject.
You mentioned air but didn't explain how air can cause the problem. Our oldest son died of this very health problem. We heard air can cause it but again no explanation was given as to how. Really would like to know.
Look at the Patient Safety Movement channel, search for Air Embolism.
If you want to make a series of viral videos, just research the effects of 5gee, emf's, and RF radiation on the human body. Or you could read The Invisible Rainbow and review it.
P r o m o s m
I just got out of the hospital yesterday for an unprovoked PE. Im 47 years old in very good shape with no known risk factors. Went to 3 emergency rooms before they found this. My troponin levels were 9000. So they thought heart attack but the CT showed a small blood clot in my right lobe. Im so confused and tbh very scared. I’m scared I’ll have a recurrence since they don’t know why it happened
Are u on thinners now? Have genetic and acquired labs done to rule out cause.