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Blood clot in the lung (pulmonary embolism)

July 8th, 2015


Blood clot in the lung (pulmonary embolism)

Blood clot is always referred to as a bad thing for health because it can cause many health problems such as heart attack (if it blocks the coronary arteries) or stroke (if it blocks the blood vessels connected to the brain).

If blood clot is formed in the blood vessel in the legs, which is common in heavy smokers and diabetics, that person will have pain in the legs, especially at the calves, when he walks. For diabetes patients, this can be a serious condition and the toes, legs or arms might even have to be cut off. However, blood clot is not all bad. It is formed naturally by our body to respond to injury inside and outside the body.

Blood clot, like everything else, can be beneficial or dangerous, depending on how it is used. When our body is wounded or scraped, blood clot will form to close the wound so that the body does not lose too much blood and the wound can heal. Without blood clot, every time we have a wound, we will not be able to stop bleeding and we will eventually die from blot lost.

However, blood clot can also do bad things to our body, if it happens at the wrong time and place, such as blood clot in the lung. Our lungs are not supposed to have any blood clot at all. This condition is rare in Thailand but more common in the West. It was assumed that we don’t have it because we eat spicy food, and chili has anti-platelet properties.

Unfortunately, it is found more and more in Thailand. I’m not sure whether it is because modern lifestyle has affected Thai people’s health, or because the tools in detecting this condition is better so we detect it more easily. The symptom includes severe chest pain and difficult breathing like myocardial infarction or heart attack patients, but the pain is like being poked by something sharp, and inhaling aggravates the pain. The condition is as fatal as heart diseases. If it worsens, the heart will be affected, and the lungs cannot supply adequate oxygen to the body.

Blood clot in the lung usually didn’t start in the lung. The main causes are from the legs, or the right chambers of the heart. When there is blood clot in the lung, the doctor will use medication to dissolve the blood clot, but sometimes operations are needed. The doctor will also have to determine where the clot came from.

Blood clot in the vein in the leg or abdominal cavity or the stomach can be caused by prolonged immobility of chronic patients, accidents, operations at the leg or the hip or some type of cancer. Also, sitting still for a long time, especially while travelling by plane when passengers tend to drink less water, can also cause blood clot in the legs, known as Economy Class Syndrome, as it usually happens to economy class passengers who have to sit in a small seat and cannot get up and move around the plane much.

Recently, a woman in her 60’s came to see me at the hospital because her right calf was swollen and painful. She had had the symptom for about a week. She told me that a few days before it began, she had just flown back to Thailand from Europe, which took about 10 hours. While in Europe, she had to sit on the bus for a long time for about a week during her wonderful holidays trip. In the flight, she was so tired she fell asleep with her legs bended and she didn’t eat or drink anything throughout the flight. First she thought the pain was due to too much walking, but before she came to the hospital, she also felt pain in the chest and could not breathe.

I checked her body and heart and suspected that it could be blood clot in her legs and lungs. My suspicion was confirmed to be true after an X-ray examination. She was treated with blood clot dissolving and anti-platelet medicines. Later she came back because of bleeding in digestive tract due to gastric ulcer. Since she was taking anti-clot medicine, the bleeding would not stop. I had to tell her to stop taking the medicine but recommended that she refrain from long haul travel. I also taught her how to exercise during the flight.  Soon after that she could resume her yearly holidays trip to South America.

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.


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