A pulmonary infarction is a blockage of blood vessels in the lungs. Pulmonary infarction is a common consequence of a pulmonary embolism and can sometimes be life-threatening. In the vernacular, pulmonary infarction and pulmonary embolism are often equated, but this is not correct from a medical point of view.
What is a pulmonary infarction?
According to Definitionexplorer, a pulmonary infarction is one of the diseases of the cardiovascular system and occurs very often as a result of a pulmonary embolism. Blood clots block blood vessels that lead from the lungs to the heart.
These blood clots have also traveled to another part of the body in the lungs, causing a blockage. This is caused by a thrombosis (blood clot) in another part of the body. The washed-in blood clot is called an embolism in medical jargon.
If a blood clot in the lungs blocks blood vessels, there is a risk of a pulmonary infarction. The affected parts of the lungs are no longer supplied with blood and can die off in the worst case. The death of parts of the lung is called a pulmonary infarction.
Causes
A pulmonary infarction or a pulmonary embolism is triggered by a thrombosis in the body. In the vast majority of all cases, this is a thrombosis in the large veins of the legs. In addition, thrombosis in the pelvic veins is a common cause of pulmonary infarction.
Thromboses are blood clots that have formed for a variety of reasons. If these blood clots detach from their original location, they are carried around the body via the bloodstream until they can ultimately block a blood vessel at a bottleneck. As a result, the body part behind is no longer supplied with blood.
In a pulmonary embolism, blood clots are already present in the lungs. If these lead to a blockage of blood vessels, the affected parts of the lungs are no longer supplied with oxygen. If the pulmonary embolism is not recognized and eliminated, there is a risk of a pulmonary infarction. The affected lung tissue dies irreversibly. This can become life threatening.
Symptoms, Ailments & Signs
The first signs of a pulmonary infarction are sudden shortness of breath and disturbances of consciousness such as dizziness, disorientation or neurological deficits in the arms and legs. Pain in the chest area, feelings of oppression and palpitations or an increased heart rate are also typical. The pain is localized in the pleura area and may radiate to the shoulders, stomach and arms.
In addition, various general symptoms can occur: sweating, dizziness, hot flashes and acute fatigue. The respiratory rate usually increases and hyperventilation occurs. The shortness of breath is often described by those affected as a feeling of drowning. A foreign body sensation in the throat is often reported, which usually causes pain and disappears again after a few minutes.
Coughing with sputum blood can also occur. The symptoms usually appear suddenly and only a few minutes before the pulmonary infarction. The victim then loses consciousness. If left untreated, the pulmonary infarction is fatal. Before that, there may be circulatory disorders and a number of other serious complications. In the worst case, pneumonia sets in and the lung tissue dies. This is usually followed by circulatory shock, from which the patient ultimately dies.
Diagnosis & History
In order to make the diagnosis of a pulmonary infarction, a detailed anamnesis by the doctor is first necessary. During the subsequent physical examination, the lungs are listened to, blood pressure and heart rate are measured and the body is checked for thrombosis. Another criteria for diagnosing a pulmonary infarction is the so-called Wells score or the Geneva score. This allows the risk of an existing pulmonary embolism to be estimated.
If the suspicion of a pulmonary infarction arises after these examinations, further diagnostic procedures must be initiated to confirm the suspicion.
A lung infarction can be visualized using computer tomography, in which the patient is administered a contrast agent. An ultrasound of the leg can provide information to uncover the cause of the embolism. The effects of the pulmonary infarction on the body will be determined by means of an ECG, a pulmonary blood flow monitor and a heart ultrasound.
Complications
In the worst case, a pulmonary infarction can lead to the death of the person concerned. For this reason, the pulmonary infarction must be treated urgently by a doctor. Without treatment, irreversible consequential damage can also occur in the patient. Those affected primarily suffer from thrombosis.
Pain in the chest and ribs also occurs, which significantly reduces the quality of life. In most cases, this also significantly restricts the movement of the patient, so that the everyday life and work of the person concerned is also restricted. Shortness of breath also occurs due to the pulmonary infarction and the internal organs are no longer supplied with sufficient oxygen.
As the disease progresses, coughing up blood occurs. The internal organs can be damaged due to the insufficient supply of oxygen, and in most cases this damage is irreversible. Treatment of pulmonary infarction is acute and usually does not lead to any particular complications. However, the further course depends heavily on the cause of the heart attack, so that a general prediction of the course of the disease is usually not possible. It is not uncommon for the patient’s life expectancy to be significantly reduced.
When should you go to the doctor?
In the event of a pulmonary infarction, the emergency doctor must be called immediately. When the first signs such as sudden chest pain or shortness of breath are noticed, the person concerned is best taken to the nearest hospital. If the symptoms persist for a few hours and get worse over time, there is a reasonable suspicion that it is a case of a lung infarction, which must be examined and treated by a doctor in any case to rule out complications.
Risk factors include being bedridden for a long time and a history of cancer. Patients who suffer from deep pelvic and leg thrombosis or who regularly take hormone preparations are also at risk and should seek medical help if the symptoms mentioned occur. If the complaints arise in connection with a flight, the flight attendant must be involved. If they occur during pregnancy or childbirth, the responsible doctor must be informed. A pulmonary infarction must be treated by an emergency doctor. Further diagnosis and treatment is carried out by a lung specialist, supported by internists and physiotherapists.
Treatment & Therapy
It is very important that a pulmonary infarction is treated very quickly after diagnosis. This is the only way to avoid consequential damage, such as the death of the affected part of the lung. Therefore, the top priority in a pulmonary infarction is to remove the triggering blood clot and the resulting blockage. In most cases, it is sufficient to start drug therapy with anticoagulants to dissolve the blood clot.
However, there are also acute cases that require tougher measures. In these cases, anesthesia and subsequent insertion of a venous catheter and administration of oxygen may be necessary. In rare cases, surgery may also be necessary to remove the blood clot. However, this operation is the last resort and is only performed in extremely life-threatening conditions where other measures do not promise success.
The success of treatment for a pulmonary infarction depends on many different factors. The size of the blood clot and how long it has existed are particularly important. The number of embolisms in the lungs also play a major role. In addition, of course, the general state of health of the patient is also responsible for the success of the treatment.
Previous illnesses and advanced age can make treatment more difficult. In general, however, it can be said that the sooner therapy is initiated for a pulmonary infarction, the better the chances of success. If a patient has a pulmonary infarction, this is predisposed for the rest of his life. For this reason, further blood clots must be prevented. For this purpose, anticoagulant drugs are used, which must be taken permanently.
Outlook & Forecast
A pulmonary infarction represents an emergency medical situation. Without the fastest possible medical care, the affected person dies suddenly in most cases. The prognosis improves with prompt treatment. It should be noted, however, that consequential damage can occur even if you act immediately.
Irreparable damage to the lungs is possible, which can lead to a restriction or permanent disruption of the ability to breathe. In these cases, only a donor organ can help to alleviate existing symptoms in the long term. Transplantation comes with numerous risks and complications. In addition, it cannot be estimated in advance whether the donated organ will be successfully accepted by the organism. The prognosis is usually unfavorable if the person concerned is advanced in age and other diseases are present. In addition, the prospect of successful treatment depends on the size of the blood clot that caused the pulmonary infarction.
It cannot be ruled out that there are other clots in the organism and there is a risk of further damage. If the patient is in generally very good health and immediate medical care is provided, the patient’s survival can be assured. If no complications occur, freedom from symptoms is possible. Nevertheless, the risk of complications and secondary diseases is high.
Prevention
In many cases, pulmonary infarction can be prevented. Risk factors include obesity and nicotine use. But even after operations or in bedridden people, there is an increased risk of thrombosis and thus also of a pulmonary infarction. In these cases, thrombosis stockings prevent the formation of blood clots.
Aftercare
The lack of blood flow to the tissue of the lungs leads to irreversible damage to the tissue. For this reason, a pulmonary infarction requires ongoing aftercare aimed at containing the various symptoms or keeping them under control.
Due to the fact that many vessels are subject to occlusion, the right ventricle has to work harder than usual. If this is overwhelmed, it can lead to a total failure of the right side of the heart. Heart malfunctions can also occur. Those affected can suffer life-threatening cardiac arrhythmias.
Those affected should ensure that no harmful germs can spread in the lung region, as this can lead to harmful inflammation. Inflammation of the pulmonary lining can also occur. Follow-up care should also focus on recognizing complications such as pulmonary hypertension in good time and averting them at an early stage. In this case, in order to be able to resist the closure, the heart has to continuously increase its pumping capacity. This can lead to high blood pressure in the lungs, which is harmful to the heart. Regular monitoring of heart activity and the lungs themselves by a doctor is therefore essential.
You can do that yourself
A pulmonary infarction is a medical crisis that requires immediate notification of the emergency doctor. As a rule, the person affected cannot take any self-help measures during an acute pulmonary infarction. First responders should attempt to calm the patient after making the emergency call. The cause of a pulmonary infarction is often a pulmonary embolism, which puts a heavy strain on the cardiovascular system. If the patient panics, this increases the strain on the circulatory system even further. First aiders should therefore ensure that the patient calms down and moves as little as possible. It is best for the affected person to sit in a comfortable chair or lie down with the upper body slightly elevated.
If the patient is unconscious, the pulse and breathing must be checked constantly. If cardiac arrest occurs, immediate resuscitation measures are required. First responders must perform chest compressions and mouth-to-mouth or mouth-to-nose resuscitation. CPR should not be interrupted until the patient regains consciousness or before ambulance arrives.
However, those affected should not let a crisis develop in the first place, but should consult a doctor at the first sign of an impending pulmonary infarction. A pulmonary infarction rarely comes suddenly, but is usually indicated by characteristic symptoms. These include, in particular, chest pain or pain in the area of the ribs, shortness of breath and coughing up blood.
