A disease accompanied by blockage of the branches of the pulmonary arteries. Pulmonary infarction is a serious respiratory disease. Blockage of the pulmonary branches is associated with the formation of a blood clot. More often than not, this disease is the cause.

Cardiac pathology includes various lesions of the heart muscles. Mainly arrhythmia, myocardial infarction and diffuse lesions of the heart muscle. What exactly are the disorders that occur in the heart muscle?

The disorders are associated with heart failure. And also against the background of increased blood clotting. In this case, blood clots form in the right heart. These formations are carried by the blood flow into the pulmonary vessels.

Embolism occurs when the veins of the systemic circulation are damaged. Provoking factors are gynecological operations. Also, the risk of embolism is associated with surgical interventions on the abdominal organs.

Various injuries can cause disruption of blood flow. Fractures of tubular bones especially occur. With this pathological condition, a fat embolism can form.

A pulmonary infarction may be accompanied by the development of various complications. Including pneumonia. Which is also a consequence of pulmonary infarction. An inflammatory process occurs in the lungs.

Also, this disease can provoke the development of pleurisy. Pleurisy can be hemorrhagic. Which is also the most serious complication.

During infectious processes, extensive suppuration occurs in the blood clot. In this case, the suppurative process breaks into the pleura. This situation contributes to the development of purulent pleurisy. Which is also the most dangerous to human health.

The size of the infarction matters in the development of the disease. At the same time, large heart attacks lead to even more serious complications. Up to and including death.

These complications carry many consequences. The recovery process is most delayed. Especially if the symptoms are most severe.

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Symptoms

With a pulmonary infarction, symptoms develop suddenly. In this case, pain develops. Moreover, than . The initial symptoms of the disease are:

• sharp chest pain;
• dyspnea;
• cyanosis;
• hemoptysis;
• cough;

All these manifestations of the disease can provoke the development of collapse. If help is not provided on time. Therefore, it is urgent to provide assistance to the patient. This reduces the risk of fatalities.

At the site of the heart attack, dullness of sound and weakening of breathing are observed. Since the formation of blood clots interferes with the normal functioning of the respiratory system. Collapse is the most life-threatening condition.

A pulmonary infarction is characterized by a rise in temperature. This is due to an inflammatory response. The inflammatory response is often a consequence of pathological disorders.

The disease develops on the second day after blockage of the branches of the pulmonary artery. Painful sensations are sudden. At the same time, they resemble the pain of angina pectoris. It intensifies with coughing and bending of the body.

If the diaphragm is affected, namely the pleura in the diaphragmatic region, then a symptom of an acute abdomen develops. This sign is also appropriate for pulmonary infarction.

In some cases, hemoptysis is possible. The discharge of sputum is streaked. There is a manifestation of “rusty” sputum.

The highest body temperature occurs with infarction pneumonia. In this case, tachycardia and arrhythmia occur. Which is also a significant sign of the disease.

Diagnostics

In the diagnosis of pulmonary infarction, anamnesis is collected. Anamnesis consists of collecting the necessary information. Namely, possible causes and concomitant diseases.

A physical examination is also very important. In this case, the presence of weakened breathing, wheezing, and noises is assumed. There is also palpation of the abdomen. Palpation reveals enlargement of the liver and its pain.

Laboratory diagnostics are used. Mainly a general blood test. As well as a biochemical blood test. The blood picture shows moderate leukocytosis and the presence of total bilirubin.

In diagnosing the disease, consultation with a pulmonologist and cardiologist takes place. Since the disorders affect not only the lungs, but also the cardiovascular system. Therefore, a comprehensive diagnosis is necessary.

Upon consultation with a cardiologist, certain abnormalities are discovered in the cardiovascular system. These violations are characterized as follows:

• systolic murmur;
• fine wheezing

An ECG is also performed. This reveals signs of heart overload. Right bundle branch block may be observed. ECHO provides more informative information.

ECHO studies reveal pathological conditions of the right ventricle. A blood clot may also be detected in the right side of the heart. Which is also a significant indicator.

Ultrasound diagnostics of the lower extremities is very relevant. This makes it possible to identify various disorders of venous outflow. Including the presence of deep vein blood clots.

Lung radiography is also used in diagnosis. This makes it possible to determine pathological conditions in this organ. Namely, expansion of the root of the lung.

Prevention

In the prevention of pulmonary infarction, timely treatment of concomitant diseases takes place. Including diseases accompanied by the formation of thrombophlebitis. It is known that thrombophlebitis occurs in a number of cases.

The most common reasons for the formation of thrombophlebitis include lack of necessary physical activity. Long sedentary work. Therapeutic exercises may also be needed.

Some therapeutic measures, such as gymnastics, can prevent the development of thrombophlebitis and its consequences. Therefore, therapeutic exercises are a significant preventive measure.

The disease can develop after surgery. Therefore, it is very important to follow certain rules to prevent surgical complications. Early rise is recommended. Moderate physical activity (as indicated).

In the prevention of the disease, intravenous infusions take place. In this case, the timing of the use of intravenous catheters must be observed. This is necessary to prevent thromboembolism.

In the presence of thrombophlebitis of the lower extremities. Especially after surgery, wearing compression stockings is very important. This allows you to prevent possible complications. This complication is pulmonary infarction.

Treatment

Anticoagulants are of great importance in the treatment of pulmonary infarction. However, this treatment should be started immediately. This helps prevent possible complications.

The most widely used anticoagulant is heparin. Mostly in a dosage of twenty-five or thirty thousand units. Then dicoumarin, neodicoumarin, and pelentan are used.

However, the use of these drugs is not limited to just one prescription; direct monitoring is important. Monitoring involves daily determination of prothrombin and coagulation. There are certain rules.

I do not reduce prothrombin below fifty percent. Coagulation should occur in sixteen or eighteen seconds. Thanks to this treatment, the risk of repeated embolisms and thromboses is reduced.

Also in the treatment of the disease is the removal of spasms. Papaverine is administered intramuscularly. This eliminates pain.

Caffeine, camphor and cordiamin are administered. These drugs are most necessary for pulmonary infarction. If an inflammatory process is detected, then antibiotics are used.

It is also important to carry out treatment in a hospital setting. This allows you to avoid possible consequences. And also eliminate complications.

In adults

A lung infarction in an adult can be a consequence of some pathology. Moreover, these pathologies are associated with disorders in the hematopoietic system. The hematopoietic system may be associated with cardiac activity.

Women are more susceptible to pulmonary infarction than men. This is due to various conditions of the female body. It is known that the provoking factors in this case are:

• postpartum period;
• malignant tumors

Malignant tumors can also develop in men. Most often, this pathology causes a lot of complications. Ultimately leading to deaths.

Adults often experience different symptoms. The most common symptom is chest pain. Therefore, it should be distinguished from angina pectoris. Also common symptoms are:

• tachycardia;
• cyanosis;
• hemoptysis;
• hypotension;
• cough;
• pale skin

From the abdominal organs, intestinal paresis is observed. Dyspepsia may also be present. But this phenomenon is not common in this case.

In children

Pulmonary infarction in children occurs after infections. Which is pneumonia, typhoid fever. Also associated factors are the development of scarlet fever and influenza.

A feature of the disease in children is the small size of the infarction. At the same time, they do not contribute to the development of pronounced symptoms. But in older children, bloody sputum is observed. It is a sign of disease.

A common symptom in older children is tachycardia. And also shortness of breath. This is the most common symptom in childhood. If these symptoms are present, a diagnosis must be made.

Diagnostics will involve the use of various techniques. Anamnesis collection and ultrasound diagnostics take place. As well as laboratory tests.

Laboratory methods are the most informative. Depending on the age of the child, x-rays are prescribed. An ECG may be ordered. Consultation with a pulmonologist and cardiologist is very important.

Forecast

In case of pulmonary infarction, the prognosis directly depends on the presence of complications. And also the treatment carried out. More precisely, its effectiveness.

A major role is played by the presence of concomitant diseases. Since infectious diseases worsen the prognosis of the disease. This is something to keep in mind!

Only correct treatment therapy and timely diagnosis improve the prognosis. Immediate treatment is also very important. Namely, the use of anticoagulants.

Exodus

Pulmonary infarction may be characterized by sudden death. This occurs with heart failure. Since the heart in this case has a number of pathological disorders associated with thrombophlebitis.

The presence of relapses, pneumonia during pulmonary infarction leads to an unfavorable outcome. Since the process is often aggravated by suppurative foci. This significantly worsens the picture of the disease.

In the presence of pulmonary edema, the prognosis is also worst. However, treatment must be comprehensive. Only complex therapy will improve the outcome of the disease.

Lifespan

With a lung infarction, life expectancy may not be reduced. Especially if the necessary treatment has been carried out. And also there are no complications.

If the disease is aggravated by other concomitant pathologies, then life expectancy may decrease. Especially in the presence of suppurative processes. This process will be quite difficult to stop.

Attention must be paid to cardiac disorders. Therefore, they take certain medications. To reduce the risk of developing heart failure. This increases the quality of life and its duration!

Most people think of a heart attack as a disease of the heart muscle. Few people know that this disease can also affect the lungs. Pathology develops against the background of circulatory disorders in this system. It causes death in 40% of people over 50 years of age.

Medical certificate

Pulmonary infarction is actually similar to the disease of the same name, which affects the heart muscle. Both processes develop against the background of a sharp cessation of blood circulation in a certain area of ​​the organ. As a result, oxygen starvation occurs, and as a result, healthy tissues atrophy. The main difference is that pulmonary pathology is not a fatal condition. Only in the absence of therapy and the development of complications can it lead to the death of the patient.

Main reasons

The primary cause of pulmonary infarction is considered to be thrombus formation in the body's vascular system. Most often, blood clots form in the veins of the legs and pelvis during prolonged periods without movement. For example, in the case of skeletal traction after a fracture or surgery.

Once formed, blood clots, along with the blood flow, first enter the right side of the heart and then into the lungs. “Traveling” blood clots are also called emboli. Therefore, in the medical environment you can find another name for the cause of a heart attack - pulmonary embolism or PE.

Among the factors that act as provocateurs for the formation of blood clots, doctors identify the following:

• advanced age;
• violation of the blood clotting process;
• oncological diseases;
• catheters installed in large veins;
• heart failure;
• obesity;
• smoking;
• use of estrogens as oral contraceptives.

Significantly increases the risk of pulmonary infarction, anemia, nephrotic syndrome.

Pathogenesis of the disease

The pathology develops from several hours to days. After the acute phase, salt deposits begin to be deposited in the affected tissues. This period lasts up to 7 days.

An area of ​​a person's lung that has suffered from oxygen deficiency resembles a pyramid. Its apex is directed towards the root of the organ, and the base is opposite. As the pathological process develops, the tissue in this area acquires a cherry tint. They become dense in consistency and visibly protrude over healthy areas. The blood supply to the pleura, located close to the affected part of the lung, does not change. However, in appearance it becomes matte, and after some time it becomes dull. Bloody secretions may accumulate in the pleural cavity.

Oxygen starvation of soft tissues leads to their damage. If blood rushes into this area from neighboring healthy areas, a hemorrhagic form of infarction develops. When an infection attaches to the affected area, infarction-pneumonia occurs. It significantly complicates the course of the underlying disease.

Clinical picture

Symptoms of a pulmonary infarction vary depending on the area of ​​the lesion and the general health of the patient. With minor injuries, a pronounced clinical picture is usually absent. The disease is detected accidentally, for example, during X-ray diagnostics. However, even in this case, obvious signs disappear after 7-10 days.

With severe damage to the lung tissue, symptoms of acute vascular blockage appear. Patients may complain of acute chest pain and inspiratory shortness of breath. The cough is dry at first, then becomes moist with the release of dark, foamy sputum. If blood streaks are observed in the secretion, a hemorrhagic form of infarction can be suspected. The cause of its occurrence is the rupture of a vessel clogged with thrombotic masses.

Another symptom of a pulmonary infarction is shortness of breath. Its appearance is accompanied by pale skin and the release of sticky and cold sweat. Among other manifestations of pathology, doctors note: shallow breathing, thread-like pulse, chills and fever.

Course of the disease in children

This pathology is also possible in young children. It is usually preceded by previous infections (typhoid fever or pneumonia). Concomitant development factors are considered to be severe influenza and scarlet fever.

A heart attack in children is characterized by a small area of ​​damage. Therefore, there are no obvious clinical signs. In adolescence, the pathology is manifested by the release of bloody sputum, tachycardia, and shortness of breath. If these symptoms appear, you should immediately consult a doctor and, if necessary, undergo a course of treatment.

Diagnostic methods

Identification of the disease begins with interviewing the patient, studying his medical history and main complaints. These issues are dealt with by a cardiologist or pulmonologist. At the next stage, the doctor listens to the airways for wheezing or bubbling sounds. After this, blood pressure is measured and the abdomen is palpated.

To eliminate errors in diagnosing pulmonary infarction, the patient must try to describe the symptoms that are troubling him as accurately as possible. Quite often this pathology is confused with pneumonia. As a result, treatment is delayed and health-threatening complications develop. To prevent this, it is important to understand that pain during a heart attack appears much earlier than fever or chills. In the case of pneumonia, fever first occurs, and only after that the clinical picture is complemented by pain and blood in the sputum.

At the final stage, the patient is prescribed blood tests. A heart attack is indicated by an increase in bilirubin with a normal white blood cell count. Diagnosis also involves the appointment of x-rays and computed tomography. Using these research methods, it is easy to detect the presence of pathology in the body.

Drug therapy

Pulmonary infarction is a serious condition that requires emergency medical care in a hospital intensive care unit. Therapy is usually long-term and complex. The patient is simultaneously prescribed several groups of drugs to dissolve blood clots and relieve symptoms of the pathology.

Therapy begins with fibrinolytics (“Streptokinase”, “Urokinase”). However, they are contraindicated in pregnant women and people who have recently had a stroke. Additionally, direct/indirect anticoagulants are prescribed. Preference is usually given to Heparin. This drug prevents the blood clot from increasing in size and stops the further process of clot formation. In case of acute pain, narcotic analgesics (for example, Morphine) are used. They relieve discomfort and shortness of breath, improve blood circulation.

After the patient’s condition has normalized, treatment of pulmonary infarction includes the use of antibiotics and symptomatic medications. Drugs from the first group are necessary to prevent inflammation and suppuration. The most commonly used are Azithromycin, Ceftriaxone and Ciprofloxacin. Injections of glycosides help ease the work of the heart. To accelerate regenerative processes in soft tissues, Trental is used.

Specific therapy lasts no more than 10 days. Long-term use of drugs can lead to osteoporosis and thrombocytopenia.

Surgery

If there is a high probability of relapse or there are contraindications to drug therapy, surgery is recommended. It involves the installation of vena cava filters in the renal veins. They allow you to stop the movement of a blood clot on its way to a person’s lungs. The operation itself is performed using local anesthesia. After the procedure, the patient spends several more days in a hospital under the supervision of doctors.

Prognosis for recovery

It is quite difficult to make a prognosis for a pulmonary infarction. In this matter, everything depends on the degree of organ damage and timely treatment. Delay in diagnosis can lead to irreversible destruction of lung tissue. Mortality with this pathology ranges from 5 to 30% of cases. A history of heart failure and repeated thromboembolism significantly increases the likelihood of death.

Possible complications

Negative consequences of pulmonary infarction are possible in the absence of timely and competent therapy. Among them, the most common pathological conditions are:

1. Post-infarction pneumonia. Appears 10-14 days after the main illness. It manifests itself as a sore throat, dry cough with the release of a small amount of sputum.
2. Purulent pleurisy. This problem is a consequence of infection of the pleural cavity. It is characterized by chills and tachycardia, cyanosis, chest pain and cough. The mortality rate for this disease is 20% of the total number of cases.
3. Spontaneous pneumothorax. It occurs due to the penetration of air from the alveoli directly into the pleural cavity. The result is acute chest pain and fear of death. Patients are forced to periodically change positions to find the most comfortable one.
4. Scarring of the lung. After a heart attack, they can have different sizes. With multiple formations, the patient has difficulty breathing. If the pathology is not treated, it can transform into cardiopulmonary failure.
5. Aneurysm rupture. The disorder is manifested by burning chest pain, a sudden drop in blood pressure, and symptoms of cardiogenic shock. Delay and failure to provide medical care can cost the patient his life.
6. Gangrene of the lung. This is a destructive process in the soft tissues of the organ, caused by the influence of pathogenic flora. The first sign of gangrene is bad breath. Then the patient’s sputum production increases, hemoptysis, chills and fever appear. He is losing weight dramatically. The disease is severe. In the absence of therapy, sepsis develops, and death cannot be ruled out.

The listed complications of pulmonary infarction can cost the patient his life. Therefore, you should not start the pathological process and immediately begin treatment.

Prevention methods

Signs of pulmonary infarction significantly worsen the patient’s quality of life. To prevent their occurrence, it is necessary to engage in prevention. Preventive measures are aimed at eliminating factors contributing to pulmonary vascular obstruction. We are talking about combating venous stagnation in the lower extremities in order to prevent the development of thrombophlebitis. Anticoagulants are used for this. The choice of specific drugs, their dosage and duration of use are determined by the doctor.

For people at increased risk of pulmonary infarction, a high-quality foot massage has a therapeutic and preventive effect. Experts also recommend:

1. Wear compression garments, especially after leg surgery.
2. Do not take medications that contribute to the development of hypercoagulability.
3. Engage in the prevention of acute infectious diseases.

With timely diagnosis and provision of qualified medical care, you can live a full life even after a pulmonary infarction. It is important not to neglect preventive measures and follow the doctor’s recommendations.

Every person should take care of their health. And this concern is expressed not in self-torture with diets and physical activity, but in an annual medical examination. Often, many serious diseases are asymptomatic and are discovered accidentally during a medical examination. For example, a pulmonary infarction may have no symptoms. However, this condition is dangerous due to its consequences. What is a pulmonary infarction, what manifestations should cause alertness and force a person to immediately consult a doctor?

Description of the disease

There are many reasons for the development of this disease. But regardless of the factors, a heart attack develops due to blood clots, which, once in the vessels of the lungs, obstruct blood flow. The symptoms of this disease are similar to myocardial infarction. However, it is developing much more rapidly. Within 24 hours, the section of the lung supplied by the artery blocked by the thrombus completely loses its function, causing pulmonary failure.

Unlike myocardial infarction, which often causes death, pulmonary infarction is rarely fatal. But the lesion, due to its failure, is subject to bacterial attacks, which leads to infection of the organ and can cause gangrene. Death occurs when a blood clot completely blocks the blood flow in a large vessel.

It should be noted that infarction in the right lung develops twice as often as in the left. In this case, it is the lower lobes of the organ that are most susceptible to dangerous disease.

Main reasons

The most common causes of pulmonary infarction are concomitant cardiovascular diseases. These include:

• coronary heart disease;
• atrial fibrillation;
• myocardial infarction;
• mitral stenosis;
• cardiomyopathy;
• infective endocarditis;
• heart failure and others.

Their peculiarity is that the formation of blood clots, as a rule, occurs in the right atrium, and then they are carried along with the bloodstream into the arteries of the lungs.

Other pathologies that often contribute to blood clots entering the lungs include varicose veins of the lower extremities, as well as various thrombophlebitis.

Not only blood clots can cause a pulmonary infarction, but also other foreign matter that enters the bloodstream, for example, fat particles that enter the bloodstream as a result of a fracture of long bones. In this case, a fat embolism develops, in which fat particles clog small vessels and capillaries.

Risk factors include people who have suffered fractures of the lower extremities, as a result of which they have to remain immobile for a long time. With just one week of bed rest, the risk of blood clots in the lungs increases significantly.

Other reasons for the development of a dangerous condition include the following:

• postpartum period;
• operative delivery;
• surgeries performed on the abdominal organs and chest;
• gynecological operations;
• surgery to remove hemorrhoids;
• tumors (both benign and malignant);
• iron deficiency anemia;
• rheumatism;
• sepsis;
• increased blood clotting;
• increased content of red blood cells in the blood;
• burns;
• infectious diseases of the kidneys and liver.

Secondary factors causing the development of pulmonary thrombosis include the following:

• age over 60 years;
• obesity;
• long-term hormonal therapy;
• splenectomy;
• taking medications that increase blood clotting;
• chemotherapy and radiation therapy.

Classification

There are three types of pulmonary hypertension:

• massive, in which blockage of large arteries occurs;
• submassive, developing due to blockage of the middle arteries;
• lung, due to which blood clots enter the small pulmonary arteries.

Pulmonary infarction is also divided into types:

• primary (during the diagnostic process it is not possible to determine the source of the blood clot detachment);
• secondary, developing against the background of a complicated course of concomitant diseases, for example deep vein thrombosis.

This disease can be complicated if it leads to the development of a lung abscess or other pathological conditions, or uncomplicated.

When a blood clot enters the pulmonary artery, a blockage of an area of ​​the pulmonary parenchyma occurs, as a result of which the damaged lung tissue is filled with blood entering it from areas with normal blood flow. In this case, hemorrhagic pulmonary infarction develops, followed by the development of infarction-pneumonia. If an infected blood clot enters the artery of the lung, damage to the organ tissue occurs, which leads to the development of an abscess.

Features of the development of the disease

An increase in intravascular pressure in the lungs is associated with blockage or narrowing of the lumen of blood vessels, which occurs during a reflex spasm of the pulmonary artery. It can also be caused by the release of biologically active substances, which include serotonin, histamine and thromboxane. During this period, the oxygen content in the blood decreases. A heart attack occurs within 24 hours after a vessel is blocked. It goes through the full development stage within 7 days.

The manifestations of a heart attack and their intensity depend on the size and number of vessels blocked by blood clots, as well as on the presence of concomitant diseases of the heart and lungs.

Typically, the first signs of pulmonary thrombosis occur within 2-3 days after the pulmonary artery becomes blocked. A person experiences acute chest pain, identical to that experienced with angina pectoris. In this case, pain intensifies when coughing, body movements and breathing. It should be noted that pain occurs suddenly against the background of general good health. This feature helps to distinguish pulmonary infarction from angina pectoris.

The cause of painful sensations is the development of reactive pleurisy in the area of ​​the lung, necrotic as a result of cessation of blood supply. The patient also produces sputum streaked with blood. In this case, 2-6% of patients experience pulmonary hemorrhage.

Another sign of a pulmonary infarction is an increase in body temperature. If a heart attack develops, pneumonia is not necessary, but the temperature may exceed 39°C. In this case, the patient produces dark brown sputum. The high temperature can last for 1-2 weeks.

Other possible symptoms of pulmonary infarction include the following:

• dyspnea;
• increased heart rate;
• heart rhythm disturbance;
• the skin turns pale or acquires a bluish tint;
• significant reduction in blood pressure.

The appearance of shortness of breath is characteristic not only of pulmonary infarction, but also of all heart diseases. In this way, the body tries to compensate for the insufficient supply of oxygen in the blood and avoid oxygen starvation.

When blood pressure decreases, blood supply to vital organs deteriorates, which also leads to oxygen starvation. In this case, a significant decrease in pressure can lead to collapse.

In rare cases, patients experience central nervous system disorders in the form of seizures, fainting and coma. If a person has impaired liver function, jaundice may occur. Dyspeptic symptoms may also appear. These include:

• nausea;
• vomit;
• stomach ache;
• hiccups

If the pulmonary artery is affected by an infected blood clot, pulmonary candidiasis, bacterial pneumonia, abscess and gangrene may develop.

When small vessels are affected, a person may not have any signs of the disease at all. A pulmonary infarction can only be detected during an X-ray examination.

Methods of diagnosis and treatment

Diagnosis and treatment of the disease are the responsibility of two specialists: a pulmonologist and a cardiologist. But before starting to directly assist the patient, specialists will have to find out what exactly caused the development of a pulmonary infarction.

The principle of diagnosis is to conduct an examination of the patient, as well as laboratory tests of blood and urine, which allow a preliminary diagnosis to be made. Hardware diagnostic methods help confirm it. These include:

• X-ray examination;
• Ultrasound of the veins of the lower extremities;
• radioisotropic lung scan;
• angiopulmonography.

X-ray examination reveals a wedge-shaped shadow, which is most often located on the right side. The area affected by the thrombus has the shape of a pyramid, the apex of which faces the root of the lung, and its base faces the periphery.

Pulmonary infarction should be treated as early as possible. In this case, it begins with the elimination of pain with the help of analgesics: both narcotic and non-narcotic.

Next, the patient is given medications to prevent further thrombus formation and dissolve existing blood clots. If conservative treatment is ineffective, the patient undergoes surgery, during which a vena cava filter is installed in the inferior vena cava system.

Prognosis for life and prevention of disease

This disease is not fatal. Sudden death from pulmonary infarction occurs in exceptional cases. Proper treatment eliminates all manifestations of the disease, which allows the patient to lead a normal lifestyle.

A threat to life arises in the case of severe heart disease, recurrent pulmonary embolism and complications developing after a heart attack.

A list of preventive measures to prevent the development of a dangerous disease is compiled taking into account the causes that cause it. These include:

• timely treatment of varicose veins and thrombophlebitis;
• daily physical therapy sessions;
• performing special gymnastics after surgical interventions;
• wearing compression garments for varicose veins of the legs.

I26 Pulmonary embolism

Causes of pulmonary infarction

The causes of pulmonary infarction can be hidden in many problems. Pathophysiology may contribute to this. Thus, in most cases, a detached blood clot can provoke a heart attack. It develops much less frequently against the background of an increase in the attached thrombus. A heart attack can cover either a small fragment of the lung or a fairly large area. The risk of developing the disease increases if the patient suffers from the following problems: sickle cell anemia, nephrotic syndrome, malignant neoplasms, vasculitis. Also, the likelihood of having a heart attack increases in people who have undergone chemotherapy. Epidemiology can contribute to the problem. Pulmonary infarction is a rare pathological disorder in medical practice. As for mortality, it ranges from 5 to 30%. It all depends on the severity of the patient’s condition and timely assistance provided. Immediately after a heart attack, various complications can develop, ranging from cardiovascular complications to pulmonary hypertension. It should be noted that women suffer from heart attacks 40% more often than men.

Pulmonary edema due to myocardial infarction

Pulmonary edema during myocardial infarction is characterized by a typical clinical picture. With this phenomenon, there are a number of subjective and objective symptoms. The first thing to note is that this pathological condition can develop at any time of the day. Typically, an attack begins with a feeling of tightness in the chest, a feeling of pain and weakness. Severe shortness of breath appears, it is difficult to breathe. The patient takes a typical forced position, in which fixation of the shoulder girdle makes breathing easier. The patient complains of a cough, which is initially dry and eventually accompanied by foamy sputum. Sometimes the color of the foam may be pink.

Upon percussion of the lungs, a tympanic sound is determined, and upon auscultation, a large number of different-sized moist rales are heard - from crepitating rales, formed in the alveoli and terminal bronchioles, to large-bubble rales, caused by the presence of foam in the large bronchi and trachea. When diagnosing a patient's condition, it is necessary to pay attention to changes in blood circulation. In total, there are 2 types of hemodynamic changes during pulmonary edema - hyperdynamic and hypodynamic. The first phenomenon is based on an increase in stroke volume of the heart and blood flow speed, an increase in pressure and an increase in blood pressure. This condition is typical for patients with hypertension, combined mitral valve disease, and unreasonable forced intravenous administration of fluids. The second type of disorder is accompanied by a decrease in stroke volume of the heart, a slight increase in pressure in the pulmonary artery and a tendency to decrease blood pressure. This type is characteristic of pulmonary edema, extreme degrees of stenosis of the mitral or aortic valves.

Symptoms of pulmonary infarction

The symptoms of a pulmonary infarction are typical; the victim himself can determine the occurrence of this disease. So, a lot depends on the severity of the condition. Symptoms are influenced by the size, location and number of closed blood clots. Naturally, we should not forget about concomitant diseases of the lungs and heart.

The main signs include sudden or sharply increased shortness of breath. A cough may occur, which is accompanied by mucous or bloody sputum. A sharp pain appears in the chest. The skin becomes pale and often acquires an ashen tint. Lips, nose and fingertips turn blue. The heart rhythm is significantly disturbed. This manifests itself in the form of increased impulse speed and the appearance of atrial fibrillation.

This is often accompanied by a decrease in blood pressure and an increase in body temperature. Most often, the person’s condition is very bad. In severe cases, it dies almost instantly. Therefore, it is important to recognize strange changes in time and provide assistance.

Hemorrhagic pulmonary infarction

Hemorrhagic pulmonary infarction occurs against the background of existing embolism or thrombosis of the pulmonary arteries. Because of this, an area of ​​lung tissue with impaired blood circulation is formed. The main feature of the disease is the presence of an ischemic area soaked in blood, which has clear boundaries and is dark red in color.

Such a heart attack is shaped like a cone, the base of which faces the pleura. Accordingly, the tip of the cone faces the root of the lung, and it can detect a blood clot in one of the branches of the pulmonary artery.

Several key points can lead to this condition. So, first of all, this is peripheral vein thrombosis. Thrombosis of the deep femoral veins is especially common due to weak or slow blood circulation in them. In this case, the presence of one condition is important - a tendency to increased blood clotting in weakened patients who have been on bed rest for a long time.

The phenomenon can be provoked by inflammatory thrombophlebitis. This group includes septic thrombophlebitis, which occurs with a variety of general and local infections, after injury or surgery, and with prolonged fever in the postoperative period.

Thrombosis in the heart and thromboendocarditis often provoke hemorrhagic pulmonary infarction. It is necessary to identify predisposing factors under which hemorrhagic pulmonary infarction develops somewhat more often. These include myocardial infarction, nephrotic syndrome, obesity, congestive heart failure, surgery in the lower abdominal cavity, pregnancy, and prolonged immobility.

The symptoms of this disease are pronounced and impossible to ignore. First, painful sensations appear in the armpit, in the area of ​​the shoulder blade, or a feeling of tightness in the chest. During coughing and breathing, the pain may intensify. Shortness of breath is noted. At the same time, vascular reactions are observed - the skin becomes pale, sticky cold sweat appears. In case of massive damage, jaundice cannot be ruled out.

A blood examination reveals moderate leukocytosis. During the examination, the doctor detects pleural friction, moist crepitating rales and muffled breathing. There may be an accumulation of fluid in the pleural cavity, which manifests itself as dulling of percussion sound in the affected area, weakening of breathing, bulging of the intercostal spaces and vocal tremors.

Right lung infarction

Right lung infarction is a disease that is caused by thrombosis or embolism of the branches of the pulmonary artery. In 10-25% of cases, it develops in case of blockage of the pulmonary artery.

Peripheral phlebothrombosis is preceded by the postpartum period, surgical interventions, fractures of long tubular bones, chronic cardiac failure, prolonged immobilization, and malignant tumors. Pulmonary thrombosis can cause pulmonary vasculitis, stagnation of blood flow in the lungs, stable pulmonary hypertension. A reflex spasm in the pulmonary artery system, as usual, accompanies vessel obstruction. This leads to overload of the right side of the heart and acute PH.

As a result, diffusion disturbance and arterial hypoxemia occur. Pulmonary infarction occurs mainly against the background of already existing venous stagnation. This phenomenon is hemorrhagic in nature. Infection can lead to the development of a lung leading to the occurrence of perifocal pneumonia (candidiasis, bacterial), often with abscess formation.

It is not difficult to understand that a heart attack has occurred. The main symptoms are chest pain, shortness of breath, foamy discharge during coughing and a significant increase in body temperature. Timely diagnosis and elimination of the problem is necessary.

Left lung infarction

A left lung infarction also develops against the background of thrombosis or embolism of the branches of the pulmonary artery. This phenomenon does not have any special symptoms; rather, it is typical. Thus, shortness of breath, fever, chest pain, dry cough appear, followed by sputum or foam. There may be tachycardia, cyanosis, hemoptysis, cerebral disorders, signs of myocardial hypoxia, cardiac arrhythmias and weakened breathing.

Abdominal syndrome caused by damage to the diaphragmatic pleura is observed occasionally. Intestinal paresis, leukocytosis, vomiting, and loose stools cannot be excluded. Diagnosis of the problem must be carried out immediately.

The prognosis of this phenomenon depends entirely on the course of the underlying disease. The disease can be prevented, but only if cardiac decompensation and thrombophlebitis are treated, anticoagulants are used among patients with myocardial infarction, mitral stenosis, in gynecology and surgery.

Consequences of pulmonary infarction

The consequences of a pulmonary infarction can be severe. Usually, this disease does not pose any particular danger, but it must be eliminated quickly. The development of serious complications is possible. These include post-infarction pneumonia, suppuration and spread of inflammation to the pleura.

After a heart attack, there is a high risk of a purulent embolus (blood clot) entering the vessel. This phenomenon can cause a purulent process and contribute to an abscess at the site of a heart attack. Pulmonary edema during myocardial infarction develops primarily with a decrease in the contractility of the heart muscle and with simultaneous retention of blood in the pulmonary circle. This happens because the intensity of heart contractions suddenly decreases, and acute low-output syndrome develops, which provokes severe hypoxia.

With all this, there is excitation of the brain, the release of biologically active substances that promote the permeability of the alveolar-capillary membrane, and increased redistribution of blood into the pulmonary circulation from the large one. The prognosis of pulmonary infarction depends on the underlying disease, the size of the affected area and the severity of general manifestations.

Scars after pulmonary infarction

Scarring after a pulmonary infarction is a typical consequence. After all, the disease itself is characterized by the death of part of the contractile cells of the myocardium, followed by the replacement of dead (necrotic) cells with coarse connective tissue. This process leads to the formation of a post-infarction scar.

Cell death (necrosis) occurs as a result of ongoing myocardial ischemia and the development of irreversible changes in cells due to disruption of their metabolism. Dense scar tissue at the site of necrosis is finally formed after about 3-4 months or later. With small-focal myocardial infarction, a scar may form at an earlier time. The rate of scarring depends not only on the size of the necrosis focus, but also on the state of coronary circulation in the myocardium in general and in peri-infarction areas especially.

A relatively small load during the formation of the primary scar (under certain conditions, of course) can lead to the development of a heart aneurysm (protrusion of the ventricular wall, the formation of a kind of sac), and after a month the same load turns out to be useful and even necessary for strengthening the heart muscle and the formation more durable scar. But let's continue talking about the heart attack. And now let’s talk about how acute large-focal (i.e., the most typical) myocardial infarction manifests itself.

Complications of pulmonary infarction

Complications of pulmonary infarction may include abscesses. It should be noted that minor manifestations of the problem are mostly asymptomatic. As for radiological changes, they completely disappear in 7-10 days.

Larger infarcts last longer and can lead to fibrosis; with thrombosis, the onset is gradual, collapse is not expressed; marantic infarcts also occur without pronounced symptoms, often accompanied by hypostasis or pulmonary edema, and are often diagnosed as hypostatic pneumonia.

It should be noted that hemorrhagic pleurisy is often associated with the problem. In general, it all depends on the severity of the condition. If you notice the problem in time and resort to eliminating it, there will be no serious consequences. Much depends on when the help was provided and what disease caused the pulmonary infarction. Only on the basis of these data can we make a further prognosis and talk about complications. It is important to prevent the lung from becoming infected.

Diagnosis of pulmonary infarction

Diagnosis of pulmonary infarction is carried out in several stages. So, first a comprehensive blood test is taken. This is followed by a chest x-ray. It allows you to highlight changes and detect pathologies. If nothing can be seen or the case is severe, computed tomography of the lungs is used. It gives a complete picture of what is happening.

Magnetic resonance imaging of the lungs, echocardiography and ECG are often used. All these diagnostic capabilities together give a complete picture of what is happening. Naturally, all procedures are not carried out at once. As mentioned above, it all depends on the complexity of the condition. In some cases, x-rays cannot provide all the necessary information. Other methods are used for this. In general, the presence of a problem can be determined by the symptoms. More precisely, based on the main features, everything becomes clear. But to determine the severity of the problem, you need to resort to other diagnostic methods.

X-ray for pulmonary infarction

X-rays for pulmonary infarction are of particular importance. So, in some cases, horizontal shadows are observed in the image. Typically, the disease is accompanied by the presence of pleural exudate. True, it can be established exclusively with the help of skiagraphy in the oblique position of the patient, located at an angle of 30° on the sore side. In this position, you can set the diaphragm to a higher position. The presence of pleural exudate was also observed in the embolic period, even before the development of a heart attack.

In unaffected areas, increased transparency is noticeable, they are swollen, or overstretching of the lung tissue is observed. The shadows of infarctions can be completely or largely blocked. In some cases, basal atelectasis develops.

When the diaphragm is high, a stripe-like shadow may form, reminiscent of flat atelectasis. A similar shadow can sometimes be produced by an incomplete, resolving, or healed infarction. It must be emphasized, however, that not every heart attack can be detected by X-ray examination. In addition, during periods of serious illness, children are usually not subjected to x-ray examination.

CT scan for pulmonary infarction

CT scanning for pulmonary infarction is an important procedure. Thus, computed tomography is an analysis that allows you to visualize the structures of the body. During the process, the patient is placed on a table to which a scanner is attached. It is this device that sends X-ray radiation to the tomograph through the area of ​​the body being examined and transmits the image to a computer monitor.

In the chest, this test helps diagnose underlying problems in the lungs, heart, esophagus and main blood vessel (aorta), as well as tissue in the chest area. The most common diseases developing in the chest that can be detected by CT are infection, lung cancer, pulmonary embolism, and aneurysm.

Computed tomography allows you to see changes in organs. Thanks to this study, a clear diagnosis can be made and treatment can begin. But one picture is not enough; you should also take a blood test and, if necessary, undergo other procedures. Computed tomography occupies a leading place in diagnosing pulmonary infarction.

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If there is no pain, neurolepsy is indicated with Droperidol - 2.5% solution, 2-4 ml. Naturally, the drug is administered intravenously. To destroy the foam, inhalation of oxygen with vapors of 20-50 degrees alcohol or a 10% alcohol solution of Antifomsilan is used.

If the blood pressure is normal or elevated, Furosemide is administered at a rate of 1 - 2.5 mg/kg. Immediately after using the drug, its extrarenal effect immediately appears - a decrease in the volume of circulating blood in the lungs due to its redistribution. When a pulmonary infarction begins, it is worth taking sublingual Nitroglycerin. It is used 1 tablet every 2 minutes 3-5 times.

If treatment is carried out in a hospital, then Nitroglycerin dissolved in 20 ml of isotonic solution is first administered intravenously. In this case, you need to carefully monitor your blood pressure. If the swelling does not stop, it is worth repeating the administration of the drug after 5-15 minutes. Subsequently, they move on to the drip application of Nitroglycerin in a dose of 6 ml of 1% solution per 400 ml of isotonic solution at a rate of 8-10 drops per minute.

Pentamin is also used; it is injected slowly into a vein. In this case, it is necessary to measure the pressure every 3 minutes. The effect of pentamine is particularly rapid in pulmonary edema, which occurs with a significant increase in blood pressure.

Another method of treatment is associated with the use of a peripheral vasodilator - Sodium Nitroprusside. It is administered intravenously in a dose of 50 mg dissolved in 500 ml of 5% glucose solution. The rate of administration also depends on the blood pressure numbers (on average 6-7 drops/min). In patients with normal blood pressure, treatment should begin with the administration of Nitroglycerin in the amount of 1-2 ml of a 1% solution diluted in 200 ml of isotonic sodium chloride solution. Everything is injected at a rate of 20-30 drops per minute. Lasix (80-120 mg) is also used and 0.25 ml of a 0.05% strophanthin solution is administered intravenously over 4-5 minutes.

If a person has low blood pressure, then all the drugs described above are prohibited. He is prescribed drugs for neuroleptanalgesia. 90-150 mg of Prednisolone is administered intravenously, a drip infusion of 0.25 ml of a 0.05% solution of strophanthin in 200 ml of rheopolyglucin is established. To this solution you can add 125 mg (5 ml) of hydrocortisone acetate (infusion rate 60 drops/min).

Dopamine 200 mg (5 ml of 4% solution) per 400 ml of 5% glucose solution or isotonic sodium chloride solution is administered intravenously (initial rate of intravenous infusion - 5 mcg/kg per minute), or 10 drops of 0.05% solution per minute . Naturally, these treatment regimens for heart attack are used only in a hospital setting.

Prevention of pulmonary infarction

Prevention of pulmonary infarction involves preventing the disease. It is necessary to eliminate cardiac decompensation and thrombophlebitis in a timely manner. It is advisable to use anticoagulants in the environment of patients with myocardial infarction, mitral stenosis, in gynecology and surgery.

It is important for heart attack patients to remain completely at rest. Therapeutic measures usually include the elimination of reflex influences, which can lead to serious consequences. Naturally, it is necessary to relieve pain with the use of Morphine and eliminate collapse.

Considering the main causes of pulmonary infarction, we can talk about preventive measures. First of all, if possible, you should not get up for several days after the operation. Even seriously ill patients are recommended to provide the necessary minimum of movements. Naturally, unnecessary use of medications that can increase blood clotting is excluded. Intravenous administration of drugs is limited whenever possible. For thrombosis of the veins of the lower extremities, a surgical method of vein ligation is used in order to avoid repeated embolisms. Compliance with the above measures will help reduce the likelihood of developing vein thrombosis and the risk of developing consequences.

Prognosis of pulmonary infarction

The prognosis of a pulmonary infarction depends entirely on the underlying disease that caused it. Naturally, all this is influenced by the severity of the problem and its course. The size of the infarction and general manifestations are also included in their number.

Typically, a pulmonary infarction is not particularly dangerous. It can be easily eliminated, but at the same time determining the reason for its development. The prognosis is usually favorable. But, as mentioned above, it all depends on how quickly the problem was diagnosed and quality treatment started.

In general, this disease is easier to prevent than to cure. Therefore, if you have problems with the heart and blood vessels, it is worth addressing them. After all, they are the ones who lead to the development of consequences in the form of lung damage. If everything is done correctly, the disease will not develop and the prognosis will be most favorable. Naturally, there is a possibility of negative developments. To prevent this from happening, you need to seek help when typical symptoms appear.

And pulmonary infarction is an acute process accompanied by a violation of the integrity of the blood vessel of the small circle. The arteries are usually affected.

The reason is always about the same: thrombosis, blockage of a hollow structure with a blood clot, critical increase in pressure at the local level, rupture, hemorrhage, compression of the organ parenchyma.

Then there are options. Even at the bleeding stage, the patient’s death is likely, almost instantaneously. If you are lucky, you need to monitor the person’s condition. Possible gangrene, abscess, compression of the lung with the development of respiratory failure and asphyxia.

Treatment is urgent. Conservative or surgical. Often in combination. Forecasts are vague because there are so many factors to consider.

It is based on two processes. The first and most common is thrombosis. That is, blockage of the pulmonary artery with a blood clot.

Most often it forms far from the localization of the lesion. Limbs as the main place of development. Slightly less heart. For example, after suffering injuries or other conditions.

The second option is atherosclerosis. It itself is divided into two more types. The formation of cholesterol plaques on the walls of the vessel, deposits of fatty compounds that radially envelop the endothelium, create a mechanical obstacle and prevent blood from moving at a normal pace.

Narrowing or stenosis is also a type of atherosclerosis. Accompanied by spontaneous spasm and a change in the diameter of the lumen of the vessel. Other causes, such as inflammation (arteritis) with scarring and fusion of the wall, are less common.

Be that as it may, in any case, a pronounced increase in pressure develops at the local level. Because blood has to overcome more resistance.

The risk remains during each cycle of heart contraction, that is, continuously, as long as the pathological condition is present.

The deviation involves one vessel or several at once. The further stage of development is accompanied by rupture of the artery.

This is usually not a spontaneous or random phenomenon. It is caused by stretching and thinning of tissues.

Blood pours abundantly into the intercellular space, possibly entering the chest, which will inevitably provoke inflammation.

If the patient does not die from massive leakage of liquid tissue, many complications arise. The reason is compression of the respiratory structures, blood entering the alveoli (hemorrhagic consolidation of the pulmonary parenchyma), into the chest and other damaging factors.

At each stage of therapy, you need to carefully monitor the condition of the victim so as not to miss an important moment and stop the impending threat in time.

Pulmonary infarction does not develop overnight, except in acute cases. Pathology is formed secondarily, as a response to the current disease. Usually we are talking about hypertension, abnormalities in the heart (CHD, other variants), atherosclerosis, cholesterolemia.

Symptoms are present in most cases, but they are subtle, weak, and do not motivate the person to go to the hospital.

Classification

There is no generally accepted typification of the disease in question. Pulmonary infarction can be divided into several aspects.

• The first is the number of affected vessels. Moreover, a multiple process is not always more dangerous than a single one. Depends on the type and diameter of the blood supply structures. It is clear that a rupture of an artery will be more fatal than the destruction of several smaller vessels.
• Next, etiology or origin. As a rule, pulmonary infarction is secondary to a particular disease.

But primary deviations are possible. With direct blockage of a vessel after an injury, with spontaneous formation of blood clots.

Finally, the pathological process can be classified according to the nature of its development. Acute or chronic.

The first is fatal in 95% of cases. The patient, others and even doctors do not have time to react. Massive bleeding leads to the rapid death of a person.

In the second case, progression occurs over months, years, ending in hemorrhage and dangerous bleeding. At this point, the difference is no longer great and the probability of death is identical.

Symptoms

The disease is characterized by an acute, sudden onset. An approximate clinical picture includes a group of well-being disorders:

• Unbearable chest pain. Usually from the affected lung, although not always.

Doctors and patients are confused about the location of the discomfort.

During a heart attack, a reflected nature of the syndrome is possible, a diffuse type, when it is not possible to determine the localization at all: the entire chest hurts.

The nature of the sensation is pressing, pulling, bursting, burning. There are almost no shootings. Possible pulsation, with increasing discomfort with each heartbeat.

• Dyspnea. Accompanies a person throughout the entire acute period and after it. If complications develop, the likelihood of the symptom persisting increases many times over.

The manifestation may worsen. The symptom of pulmonary infarction is present even at complete rest, it becomes more complicated with minimal physical activity, and with a change in body position it develops into suffocation and asphyxia.

This is a deadly condition. Risk of death from respiratory failure. In milder cases it gives minimal discomfort.

• Hemoptysis. The cough almost immediately becomes productive, with the discharge of liquid scarlet connective tissue, possibly with foamy sputum. In severe cases, we are talking about full-fledged bleeding, fatal for a person.
• Weakness, drowsiness, feeling tired. Asthenic manifestations arise at one moment. Associated with sudden blood loss.
• Collaptoid reaction. In response to the same factor. Accompanied by sweating, pallor of the skin, a feeling of cold, chilliness, confusion, tremor (trembling of the limbs, chin).

These are specific signs of a pathological process. In approximately 86% of cases or even more, additional manifestations develop. The reason is the formation of secondary myocardial infarction.

Why is destruction of the heart muscle also added? Since the lungs are not able to supply the blood with oxygen, ischemia of all systems occurs. This includes the organ not receiving enough nutrition. Coronary insufficiency develops.

Additional symptoms of myocardial infarction confuse the entire clinical picture and can throw the doctor off the scent, especially if there is insufficient experience. It is necessary to differentiate the conditions; you cannot hesitate. The minutes count down.

Attention:

When coronary insufficiency is added, the risk of death increases by almost 60%, regardless of the extent of the lesion.

Among other signs:

• Change in heart rate. According to the type of bradycardia. Heart rate decreases to critical levels, below 50 beats per minute.
• A sharp drop in blood pressure. Also to minimum values, which only complicates the general condition. The contractility of the myocardium decreases, the organ does not even provide itself with nutrients and oxygen.
• Nausea, vomiting. Short-term.
• Loss of consciousness.

The process continues to move along the chain. Within a matter of minutes, there is a risk of developing multiple organ failure and death of the patient.

It's not always so bad. In some cases, if the extent of the lesion is not large, there may be no symptoms at all.

At the same time, spontaneous recovery occurs quite quickly. It takes from 4 to 12 days. Treatment speeds up the process. But the violation is discovered by chance.

A picture resembling tuberculosis or pneumonia is possible. Hemorrhage is detected during an x-ray.

The clinical picture may also include neurological signs: pain, dizziness, nausea, vomiting, loss of consciousness, fainting. Generalized dysfunction of the whole organism develops. This is an extremely dangerous process.

Reasons

The factors are varied. At the early stage of care, etiology plays a secondary role, apart from the immediate immediate connection between the underlying disorder and pulmonary infarction.

Then deciding on the factor is vitally important: no one can guarantee that a fatal relapse will not occur. This is a key point in therapy.

• Cardiomyopathy. Abnormal thickening of the walls of the muscular organ, as well as expansion of the chambers (dilatation).

• Arterial hypertension. It is somewhat less likely to provoke the disorder in question.
• Excessive amount of cholesterol in the blood. Develops as a result of metabolic disorders and endocrine diseases.
• Tumors of any location. Especially malignant, infiltrating other tissues and causing hemorrhages. Also benign, compressing blood vessels and causing hemorrhage.
• Rheumatism. Autoimmune process. Accompanied by severe inflammation of the cardiac structures.
• Anemia is also the opposite phenomenon, with excess hemoglobin and thickening of the blood.

• Excessively rapid coagulation of liquid tissue. Hypercoagulation.
• Fractures, injuries of the chest bones. Other structures with the development of bleeding. The key point is mandatory hemorrhage. Because the basis in the vast majority of the situations described is the formation of a blood clot, its separation and further movement towards the small circle.

Another option is due to cholesterolemia. It develops as a result of metabolic disorders. The classic disease is atherosclerosis.

Other factors, such as arteritis, occur, but are much less common, so they are excluded last. It accounts for 3-4% of the total mass.

PE is often a factor in the development of a heart attack.- . The disease is mostly fatal; the chances of survival if a vessel ruptures are minimal, if not non-existent.

Consolidation of lung tissue (filling of the alveoli with blood instead of air) is fatal in 98% of cases or more within minutes. The rest die within a day, maximum two.

Diagnostics

It is carried out under the supervision of a cardiologist or vascular surgeon. Often a whole council works on such a “complex” patient. This may include the help of a thoracic specialist or pulmonologist.

Examinations are carried out urgently upon admission of the patient to the hospital. There is no time for long research.

They are limited to an initial examination, which includes an assessment of symptoms, a complete clinical picture, blood pressure, and heart rate. A combination of a collaptoid reaction with hemoptysis is typical. X-ray is required. Then first aid is provided.

Only then can you begin a more thorough diagnosis. It pursues two goals: to identify the consequences of an emergency condition, to determine the root cause of the disorder in order to prevent the development of relapse in the future.

The list of events is quite wide:

• Oral interview and history taking to determine key factors.
• Measurement of blood pressure, heart rate.
• Chest X-ray.
• MRI of the same area. A more preferable technique is aimed at identifying the smallest anatomical defects. Considered the gold standard.
• Coronography.
• Electrocardiography. To determine arrhythmic disorders and possible functional disorders.
• Echocardiography. Visualizes tissue, essentially an ultrasound. Used as part of early diagnosis. In a system with an ECG it gives a lot of information.
• General blood test, biochemical with determination of low- and high-density lipoproteins (bad and good cholesterol, respectively), and atherogenic index. Used for indirect confirmation of atherosclerosis.

Diagnosis is carried out quickly in order to begin to restore the patient’s original position, as far as possible within the framework of the life-threatening condition suffered.

Treatment

Early treatment is conservative. A large group of heterogeneous means is used.

As soon as a person is admitted to the hospital in acute condition, the use of a number of medications is indicated:

• Thrombolytics. The clot is dissolved and the patency of the vessel is normalized. Streptokinase, Urokinase. Some contraindications need to be taken into account.
• Antiplatelet agents, anticoagulants. Aspirin, Heparin. Normalizes the rheological properties of blood. First of all, fluidity.
• Narcotic painkillers. To relieve severe, painful discomfort.
• Antispasmodics. With the same goals. Papaverine as an option.
• A critical drop in blood pressure and heart rate, collapse is stopped with Dopamine, Epinephrine. These are dangerous means, but there are not many options.

Once completed, you can think about correcting subsequent deviations. Medicines of other groups are used:

• . Anavenol. To strengthen blood vessels.
• Means for restoring normal blood flow: Actovegin and analogues.
  Eufillin, Prednisolone to improve respiratory activity.
• Antihypertensive urgent action (as part of the relief of elevated blood pressure). It is better to limit yourself to diuretics like Furosemide.
• Cardiac glycosides are also administered to normalize myocardial contractility.

It is mandatory to use broad-spectrum antibiotics after the acute period of pulmonary infarction: cephalosporins, fluoroquinolones, macrolides and anti-inflammatory hormonal drugs (Prednisolone, Dexamethasone).

Surgical treatment consists of installing a vena cava filter in the vascular bed (inferior vena cava) to prevent blood clots from moving through the system.

Against the background of complications, resection of the lung tissue or total removal of the organ if it is inoperable is performed.

Forecast

Fog. With early initiation of treatment, good health, young age, absence of bad habits and concomitant diseases - from conditionally favorable to neutral. The risks are still too high.

With the development of negative phenomena (necrosis of the parenchyma, etc.), rapid progression - negative. If we speak on average, the survival rate is 30-40%. Or less. The data varies.

Complications

All consequences of a pulmonary infarction carry the risk of death or at least severe disability with delayed death.

• Abscess, gangrene of the lung. In the first case, a well-encapsulated area of ​​necrosis is formed. In the second - focal, and then general disintegration of the paired organ.
• Pneumothorax. The release of air from the destroyed alveoli into the chest. It has a closed character, which is not typical for this condition.
• Formation of calcifications, respiratory failure due to tissue scarring.
• Massive bleeding. As a result of further progression of the disorder or subsequent relapse.
• Sepsis. Blood poisoning with generalized inflammation of all tissues.

Complications are prevented through secondary prevention.

Pulmonary infarction is a dangerous, fatal emergency condition in most cases. Requires hospitalization and prompt treatment.

Rarely develops spontaneously. More often there is a preliminary stage, which few people pay attention to. With an integrated approach, there is a chance for recovery.