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What is a Pulmonary Embolism?

Small clots form in the blood stream all the time, made of red blood cells, platelets and some fibrin. These may travel some distance through the circulatory system before they break apart again. They form an important quick response to the bodies clotting needs in the event of injury.

There are a number of factors that lead to the formation of larger clots and their increased risk of becoming trapped, usually in the valve junction of a blood vessel. In the case of a pulmonary embolism the clot usually forms in the larger vessels of the lower limbs before being swept along, passing through the right-hand chambers of the heart and entering the lungs.

Once the large clot reaches the lungs it can become trapped in the narrower vessels where gas exchange takes place. This blockage can cause a drop in oxygen passing into the blood inducing hyperventilation, along with increased vascular resistance straining the right side of the heart. If the pressure on the heart is severe, from multiple blockages, then heart failure can occur.

What causes a Pulmonary Embolism?

Pulmonary Embolism is not a disease but instead a condition that arises from cumulative complications in the venous thromboembolism. Thrombosis usually occurs in the lower limbs and involves the occlusion of small veins by growths of platelets and fibrin. If this growth breaks off and begins to travel through the circulatory system it becomes an embolus. Once it reaches the pulmonary system that feeds blood to and from the lungs it can easily become lodged in the smaller network of vessels that allow for gas exchange.

There are usually multiple factors involved in the propensity to develop thrombosis in the first place. These factors include;

  • Hypercoagulable states caused by obesity, physical trauma or illness can increase your bodies’ tendency to coagulate blood.
  • Venous stasis describes increased blood viscosity and accumulation of thrombin and platelets in veins.
  • Immobilisation promotes localised venous stasis and the increased risk of thrombosis.
  • Surgery and trauma raise the risk of thromboembolism due to the associated immobility and inherent requirement for increased clotting.
  • Oral contraceptives and oestrogen replacement medication for postmenopausal women both increase the risk of thromboembolism.
  • Hereditary conditions can promote specific deficiencies or abnormalities in proteins and plasma formation increasing the risk of pulmonary embolism.
  • Medical illnesses can cause specific impairments, either mechanical or chemical, that increase the risk of thromboembolism. They include heart attacks, Aids and Behcet disease.

What are the symptoms of a Pulmonary Embolism?

Pulmonary Embolism can be hard to identify quickly as the main symptoms are common to a wide range of conditions. An individual suffering symptoms may complain of multiple minor symptoms for weeks before a diagnosis is confirmed. Often an individual with a pulmonary embolism will show no signs at all.

When looking at symptoms your doctor will consider your medical history and the likely associated risks of embolism. Some symptoms specific to pulmonary embolism include;

  • Abdominal or chest pain.
  • Cough, usually productive.
  • Wheezing.
  • Brief blackouts.
  • Seizures.
  • Diminished or intermittent consciousness.
  • Alert but delirious

How is a Pulmonary Embolism Diagnosed?

A doctor can confirm a diagnosis of Pulmonary Embolism following a detailed investigation of your symptoms, medical history and using specific tests to rule out other possible conditions. As pulmonary embolisms can be hard to detect having your detailed medical history will be important in determining your diagnosis.

If you suspect you have a Pulmonary Embolism you should seek an assessment with your doctor immediately. Once diagnosed we can assess your current level of lung function and target treatments accordingly.

For more information on how physiotherapy can help treat Pulmonary Embolism, or to book yourself an assessment, please contact us via email at office@physio.co.uk or ring us on 0330 088 7800.

What would a physiotherapy assessment for a Pulmonary Embolism involve?

At Physio.co.uk, we want to gain as much information as possible about your condition to ensure we give you the best treatment. In your first appointment with us, our physiotherapists will carry out an assessment which has two parts:

Subjective

A discussion between you and our physiotherapist to find out what symptoms you are experiencing, and how your condition is affecting you and your lifestyle.

Objective

An assessment to discern the presence of any pain, your current breathing pattern, respiration rate, lung volume and a series of special tests to identify the presence of any mucus retention and lung function impairment.

There can be great variation in the symptoms displayed, depending on the progression of the condition and any complicating factors. The assessment process will be important in identifying your current symptoms and needs, so that treatments can be targeted and effective.

What would physiotherapy treatment for a Pulmonary Embolism involve?

The initial medical intervention from your doctor will depend on the severity and progression of the pulmonary embolism. It will likely entail a course of anticoagulants to prevent further embolisms and possible surgical removal of any existing embolism blockages.

The simple application of compression stockings during recovery can help reduce the reoccurrence of further embolisms. Beginning a basic exercise plan under supervision of a health professional, such as one of physiotherapists, aids in recovery and can help prevent further unwanted clotting.

With this type of embolism affecting the lungs people whom receive respiratory physiotherapy as part of their treatment will tend to achieve a quicker recovery with fewer complications. Some of treatment techniques physiotherapy provides include;

  • Secretion clearance:
    • Effective / productive coughing techniques.
    • Postural drainage in sitting and lying.
    • Manual assistance, including percussion, vibrations and shaking.
  • Breathing technique retraining:
    • Controlling respiratory rate
    • Diaphragmatic breathing
    • Controlling / reducing breath volume
    • Relaxation breathing exercises
  • Education and Advice:
    • Illness cause and progression.
    • Effects of environmental and allergen factors.
    • Medication management

At Physio.co.uk you will experience personalised treatment sessions. Each appointment will be aimed at returning to your everyday activities and what you enjoy.

How can I arrange a physiotherapy assessment for a Pulmonary Embolism?

If you have been diagnosed by your doctor as having Pulmonary Embolism and are suffering from symptoms affecting your breathing and lung clearance, you would benefit from an assessment with one of our experienced respiratory physiotherapists.

You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, and give you advice on self-management techniques if appropriate. To arrange an appointment please email office@physio.co.uk or call 0330 088 7800.

Summary

At Physio.co.uk, our respiratory physiotherapists can provide specialist assessment and treatment for people with Pulmonary Embolism. We can apply a range of therapy techniques and advice to manage your symptoms and maintain the best possible level of lung function and comfort. We can also advise on activity modification to make daily living easier. Along with advice for you and your family on appropriate self-management techniques to maximise your functional ability between therapy sessions.

For more information on how physiotherapy can help treat Pulmonary Embolism, or to book yourself an assessment, please contact us via email at office@physio.co.uk or ring us on 0330 088 7800.




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