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.
Pulmonary embolism can be fatal, especially if involves a large amount of
clot. When the patient is unconscious, has low
or no blood pressure or are not breathing, clot busting or thrombolytic therapy
using medications like TPA (tissue plasminogen activator) may be considered. It
is also often considered when signs of right heart strain are present. Some
physicians argue that thrombolytic therapy should be used more often, since the
source clot is also dissolved as well as the pulmonary embolus. This therapy is
associated with a slightly greater risk of bleeding and is contraindicated if
recent surgery or significant trauma has occurred.
What is the prognosis for pulmonary embolism?
Patient survival depends upon:
the underlying health of the patient,
size of
the pulmonary embolus,
the cause of the pulmonary embolus, and
the ability for a diagnosis to be made and
treatment initiated.
The diagnosis is often difficult, and it is estimated to that there are up to
400,000 cases of pulmonary embolus that are not diagnosed in the United States
each year.
In those patients where the diagnosis is made, the mortality rate is less
than 20% when considering all patients. Usually, however, the mortality risk is
much less in most patients. The higher incidence of death occurs in patients
that are older, have other underlying illnesses, or have a delay in diagnosis.
Racial differences may also exist, but probably are due more to access to
quality care than a specific genetic difference.
How can pulmonary embolism be prevented?
As mentioned earlier, minimizing the risk of deep vein thrombosis is key in
preventing a potentially lethal illness.
In the hospital setting, the staff works hard to minimize the potential for
clot formation in immobilized patients. Compression stockings are routinely
used. Surgery patients are out of bed walking (ambulatory) earlier and low dose
heparin or enoxaparin is being used for deep vein thrombosis prophylaxis
(measures taken to prevent deep vein thrombosis).
For those who travel, it is recommended that they get up and walk every
couple of hours during a long trip.
Compression stockings may be helpful in preventing future deep vein thrombus
formation in patients with a previous history of a clot.
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.
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