What are the consequences of a pulmonary embolism?

introduction

The consequences of a pulmonary embolism are very much dependent on the severity of the pulmonary embolism.In the case of the smallest embolism, the symptoms are so minor that the embolism remains unnoticed for several months. A fulminant pulmonary embolism leads to death within a few minutes. Since the lungs are responsible for supplying the entire body with oxygen, the consequences usually affect many different organ systems. Above all, the lungs, heart and brain are affected.

In addition, the consequences of pulmonary embolisms are always highly dependent on how quickly an affected person is treated.

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What are the consequences of a pulmonary embolism?

• Consequences of lack of oxygen:

  • Organ damage (especially lungs, brain, heart, kidney)

• Consequences of the blood clot

  • Damage to the lung tissue

  • Damage to the heart due to high blood pressure

• Psychological consequences

• Multi-organ failure (failure of several organs) with possibly fatal consequences

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Consequences for the heart

The heart is most severely affected in severe pulmonary embolisms. In a pulmonary embolism, one or more vessels are blocked by a thrombus (blood clot). The area behind is no longer supplied with blood; oxygen cannot be absorbed into the blood here.

This has two effects on the body: there is an insufficient supply of oxygen and the blockage causes higher blood pressure in the pulmonary vessels.

The lack of oxygen can damage all organs in the body. Among other things, the heart can also be affected. Since every heartbeat consists of actions of the heart muscles, oxygen is consumed here. If the heart is not supplied with sufficient oxygen, this damages the individual heart muscle cells. In the worst case, tissue destruction occurs. As a result, a Heart failure (Heart failure) arise.

But not only the lack of oxygen has an effect on the heart. The increased blood pressure in the pulmonary vessels is also a challenge for the heart muscles. As a result of the blockage, the heart has to continuously pump against increased pressure. Initially, the heart muscle cells can compensate for this increased requirement, but this is not possible in the long term. Right heart failure occurs, the right ventricle dilated (enlarges) and then becomes insufficient (poorly functioning).

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Cardiac arrest in a pulmonary embolism

In the case of a pulmonary embolism, the heart demands increased pumping capacity, as the increased blood pressure in the lungs has to be pumped against.
At the same time, part of the lungs is no longer functional due to the embolism, so that the heart is supplied with less oxygen.

This combination of increased work and decreased oxygen supply can seriously damage the heart.
In the worst case, this can trigger cardiac arrest that occurs immediately.
Immediate resuscitation is necessary, but does not always end successfully.

You can read about how resuscitation is carried out in the event of a cardiac arrest in our relevant article: Cardiac Arrest - Causes & Immediate Actions

Psychological consequences of a pulmonary embolism

A pulmonary embolism can leave different traces in the psyche of the person affected, depending on the severity. The fulminant pulmonary embolism is an acutely life-threatening situation. There is shortness of breath, palpitations and profuse sweating. If the pulmonary embolism is so severe that an intermittent cardiac arrest occurs and the person has to be resuscitated, the psychological consequences are all the more severe.

Many of those affected then suffer from anxiety or panic disorders. They can no longer really trust their bodies and fear another serious illness at the slightest sign. Here it helps if professional psychological help is offered during the hospital stay and during rehab. In this way, the illness can be discussed immediately after it occurs, and the long-term psychological consequences are then usually significantly reduced.

But a less acute pulmonary embolism can also leave its mark. If only small pulmonary embolisms occur, these are often not diagnosed for a longer period of time because the symptoms are very unspecific. Most complaints such as shortness of breath and increased pulse only occur during exercise. As a result, symptoms may be dismissed as lack of exercise, signs of aging, and poor fitness. After a while, those affected feel that they are no longer being taken seriously, as nobody really addresses their complaints. Usually the problem is solved with the diagnosis, since the cause of the disease could be clarified and eliminated.

Consequences of a small pulmonary embolism

Small pulmonary embolisms are usually the result of thrombi (blood clots) that separate in small pieces from the vessel wall. These pulmonary embolisms rarely affect larger sections of the pulmonary vasculature.

As a result, you do not attract attention with acute symptoms. Instead, the symptoms gradually make themselves felt. Often the problems are initially only there when there is stress. There is a reduced physical resilience, shortness of breath and a faster increase in heart rate during exercise. Since the symptoms only become clearer over time, the problem is usually justified with a lack of fitness and increasing age.

Small pulmonary embolisms, for example, are often only diagnosed months or years after their onset. As a result, much of the damage caused by the small emboli is irreversible (irreversible). In contrast to larger thrombi, very small blood clots usually cannot be surgically removed from the pulmonary vessels. Instead, a so-called lysis therapy is carried out. Blood-thinning medication is used to dissolve the clot. However, because the thrombi remain in the vessels for a long time, this dissolution is often no longer possible. Therefore, symptoms such as shortness of breath and decreased resilience remain even after the diagnosis.

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Consequences of a bilateral fulminant pulmonary embolism

A fulminant pulmonary embolism is the most severe form of pulmonary embolism. A large thrombus (blood clot) that has suddenly loosened and washed into the lungs blocks the largest branches of the pulmonary vasculature. The blood clot can even be so large that the entire pulmonary artery is affected.

This results in three extremely life-threatening complications: Since the lungs are only supplied with little or no blood, the entire body is no longer supplied with oxygen. This damages various organs. The brain is particularly at risk. The fact that the lungs can no longer be supplied with blood also has fatal consequences for the heart. This has to pump against an infinitely high pressure, which leads to cardiac arrest within minutes. If the blood clot can be removed quickly enough, the lungs can still be totally destroyed. As long as the thrombus clogs all pulmonary vessels, the entire lung tissue is not supplied with blood. As a result, the individual cells are not supplied with oxygen and other nutrients for a certain period of time, which can lead to cell death and thus extensive tissue damage.

Can a pulmonary embolism heal without consequences?

Whether a pulmonary embolism can heal without consequences depends on the one hand on the severity of the embolism; on the other hand, first aid measures and prompt treatment of all relevant factors also play a decisive role.

The smaller the embolism, the fewer serious complications there are in the course of the process. However, with particularly small embolisms, there is a risk that they will not be discovered over a longer period of time. The chances of healing without consequences are best if the triggering blood clot can be completely removed within the first few minutes. Only in the rarest of cases are organs permanently affected. In order to prevent long-term consequences, blood-thinning therapy must always be carried out over several months. If this can be done without complications. It is very possible that the pulmonary embolism heals without consequences.

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