Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Ultrasound of the legs, also known as
venous Doppler studies, may be used to
look for blood clots in the legs of a patient suspected of having a pulmonary
embolus. If a deep vein thrombosis exists, it can be inferred that chest pain and shortness of
breath may be due to a pulmonary embolism.
Echocardiography (EKG, ECG)
Echocardiography or ultrasound of the heart may be helpful if it shows that
there is strain on the right side of the heart.
If non-invasive tests are negative and the healthcare provider still has
significant concerns, then the healthcare provider and the patient need to discuss the
benefits and risks of treatment versus invasive testing like angiography.
What is the treatment for pulmonary embolism?
The best treatment for a pulmonary embolus is prevention. Minimizing the risk
of deep vein thrombosis is key in preventing a potentially fatal illness.
The initial decision is whether the patient requires hospitalization. Recent
studies suggest that those patients with a small pulmonary embolus, who are
hemodynamically, stable (normal vital signs) and who can be compliant with
treatment, may be treated at home with close outpatient care.
Those who are unstable need to be admitted to the hospital.
Anticoagulation
The first step in stable patients with pulmonary embolism is anticoagulation. This is a two
step process. Warfarin (Coumadin) is the drug of choice for anti-coagulation. It
is taken by mouth beginning immediately upon the diagnosis of pulmonary embolism, but may take
up to week for the blood to be appropriately thinned or anticoagulated. As an
immediate solution and as a bridge until the Coumadin becomes effective, low
molecular weight heparin [enoxaparin
(Lovenox)] is administered at the same
time. It thins the blood via a different mechanism. Enoxaparin injections can be
administered as an outpatient.
It is also essential to realize that warfarin (Coumadin) is in the same family of
chemicals as rat poison. Rats eat this chemical and bleed to death internally. A
clever clinician recognized that if this process was carefully monitored, this
medication could be used therapeutically to treat clotting disorders. It is
imperative that anyone taking Coumadin be carefully monitored with blood tests
and that this medication (as with all medication) be kept in a safe place.
For those patients who have contraindications to the use of enoxaparin
(Lovenox) (for
example, kidney failure does not allow the drug to be metabolized), intravenous
heparin can be used as the first step. This requires admission to the hospital
and careful patient monitoring with blood tests.
Anticoagulation is usually suggested for a minimum of six months, but each
patient will have their treatment regimen individualized. The blood test
utilized to monitor warfarin therapy is referred to as the
prothrombin time or
PT. This test can be performed by finger stick or venous stick depending on the
laboratory procedures. Since different reagents are used to measure the
prothrombin time, a ratio has been
developed for comparison of this test between different labs. It is referred to
as the International Normalized Ratio or INR. Usually, for these clotting
conditions, your physician will want you to take enough warfarin to keep your
INR between two and three. It is very helpful for the patient to participate in their
health management by keeping a diary of their warfarin dose, the date of testing, and
their INR values.
Pulmonary Embolism (Blood Clot In The Lung) - Describe Your SymptomsQuestion: Please describe your symptoms of pulmonary embolism (blood clot in the lung).
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Deep vein thrombosis (DVT) is a blood clot in a vein located deep in the muscles of the legs, thighs, pelvis (lower torso), or arms. The most common symptoms of a deep vein thrombosis are swelling and pain in the leg that has the blood clot. A DVT is difficult to diagnose without specific tests in which the deep vein system can be examined.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude). Treatment of polycythemia depends on the cause.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-White-Parkinson syndrome, brachycardia, or heart blocks. Treatment is dependant upon the type of heart rhythm disorder.
Pulmonary hypertension is an abnormal elevation of the pressure in the pulmonary circulation caused by the constriction of the blood vessels that supply blood to the lungs. Shortness of breath and dizziness are symptoms of pulmonary hypertension. Treatment involves diuretics, blood thinners, calcium channel blockers, and using supplemental oxygen to increase blood oxygen levels.
Pulmonary edema (swelling or fluid in the lungs) can either be caused by cardiogenic causes (congestive heart failure, heart attacks, abnormal heart valves) or noncardiogenic causes such as ARDS, kidney failure, high altitude, pneumothorax, pleural effusion, aspirin overdose, pulmonary embolism, and infections. The treatment of pulmonary edema depends on the cause of the condition.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Pleural effusion is an excess fluid between the two membranes that envelop the lungs. There are two classifications of causes of pleural effusion; transudate and exudate. The treatment of pleural effusion depends on the cause.
Jet lag (desynchonosis) is a temporary disorder that results from travel across time zones. Symptoms include anxiety, constipation, headache, nausea, dehydration, diarrhea, confusion, sweating, irritability, and even memory loss.
Phlebitis is the inflammation of a vein. Thrombophlebitis is when a blood clot causes the inflammation. Phlebitis can be superficial or deeper in the veins. A blood clot deep in a vein is deep vein thrombosis (DVT). Some of the common causes of phlebitis include prolonged inactivity, varicose veins, trauma to a vein, underlying cancers, clotting disorders, etc. Symptoms of phlebitis may be mild (pain, tenderness, redness, or bulging of a vein. Treatment of phlebitis depends on the cause.
Sudden cardiac arrest is an unexpected, sudden death caused by sudden cardiac arrest (loss of heart function). Causes and risk factors of sudden cardiac arrest include (not inclusive): abnormal heart rhythms (arrhythmias), previous heart attack, coronary artery disease, smoking, high cholesterol, Wolff-Parkinson-White Syndrome, ventricular tachycardia or ventricular fibrillation after a heart attack, congenital heart defects, history of fainting, and heart failure, obesity, diabetes, and drug abuse. Treatment of sudden cardiac arrest is an emergency, and action must be taken immediately.
Bronchiectasis is a condition in which the bronchial tubes of the lung become damaged. Inflammation from infection or other causes destroys the smooth muscles of the bronchial tubes. Bronchiectasis is a form of COPD (which includes emphysema and chronic bronchitis). There are three primary types of bronchiectasis: 1) cylindrical bronchiectasis; 2) saccular bronchiectasis; and 3) cystic bronchiectasis. Bronchiectasis may also be acquired or congenital. The most common symptoms of bronchiectasis are recurrent cough and sputum production. There is no cure for bronchiectasis. Treatment is often geared toward controlling the symptoms of bronchiectasis.
Lungs RSS
Healthy Living Tips
This site complies with the