Saddle Pulmonary Embolism Causes, Risks and Prevention

Saddle Pulmonary Embolism

A saddle pulmonary embolism is a term that is used to describe bifurcation. However, the term bifurcation can sound a little confusing, and so the word “saddle” is very common. Essentially, bifurcation means that something is split into two parts, sort of the way that a saddle branches across both sides of a horse. Thus a saddle pulmonary embolism is one that separates the main artery, or one of its branches, of the lung. An embolism is any substance that travels in the body through the blood stream from one part of the body to another. Most commonly, an embolism refers to a blood clot. However, embolisms can also be comprised of fat, air or even components of some drugs. Blood clots in lungs can be very serious and can lead to severe health consequences and additionally, medical life threatening emergencies.

The most common of all pulmonary embolism causes is deep vein thrombosis (DVT). When blood clots form in the deep veins of the legs or in the pelvis, they can break off and travel upward and travel to the lungs. There are also some health conditions that can make the blood more prone to clotting and some of these may be responsible for causing blood clots in lower parts of the body.
The symptoms of a saddle pulmonary embolism are the same as other types of embolisms that do not bear the characteristic straddled presentation. Most of the time, these symptoms come on very suddenly, and changes in breathing including shortness of breath and an increased rate of breathing may occur. Additionally, coughing up blood can occur in cases of embolism, and this phenomenon is known as hemoptysis. Chest pain may also occur, and pulmonary embolism symptoms concerning chest discomfort may be similar to pleurisy and may worsen with breathing or coughing. More severe symptoms may also present including changes in color to the fingers and lips, a result of diminished oxygenation from circulatory troubles. In rare cases, a saddle pulmonary embolism may lead to jaundice and edema (swelling) due to fluid buildup and congestion.

Pulmonary embolism diagnosis of any kind starts with symptom identification in order to determine if further diagnostic testing is required in order to obtain a diagnosis. These symptoms can help to predict the probability of an embolism. A tool known as “The Wells Scale” can help doctors determine the likelihood of an embolism based on certain criteria that may eliminate the need for further diagnostic testing. Sometimes, blood tests will be used to determine whether or not a pulmonary embolism is present if the condition is not life threatening. A CT scan can help to detect a saddle pulmonary embolism, and the tool is further useful because it is considered non invasive and can also serve as a secondary means of diagnosis if other conditions of the lung are present. Sometimes, tools used for monitoring the heart like echocardiograms may be used to quickly rule out a heart attack, since symptoms can share some similarities.

Because DVT is the single biggest risk factor in the development of a pulmonary embolism, many of the risk factors associated with developing DVT in the first place are also considered risk factors for developing a pulmonary embolism. For instance, long periods of lying in bed can greatly increase the risk of a DVT. Therefore, people with serious illness that are often confined to beds for long periods of time may be more at risk. Being overweight and smoking can also contribute to developing a DVT and thus similarly, increase the risk of a pulmonary embolism. New studies have also found that people with certain types of cancer, such as those of the blood and the lungs, may be more likely to develop blood clots in the lungs and thus have a greater potential risk of having an embolism. Additionally, a saddle pulmonary embolism may be more likely in persons using estrogen based contraception methods.

Pulmonary embolism prevention therefore can be focused on eliminating the contributing factors to developing a DVT. Eliminating risk factors like smoking as well as increasing physical activity can majorly impact the likelihood that clots will form and travel. Additionally, many people employ the use of compression garments and other circulation improving tools in order to keep blood traveling properly throughout the body.

The primary method of pulmonary embolism treatment is the use of anticoagulants or blood thinners. Most of the time, these are administered in the hospital and then continued indefinitely upon release, sometimes for the remainder of a person’s life. In severe cases, enzymatic medications may be used to break up the clot, and sometimes filters are used in order to prevent subsequent clots from causing additional problems. In very rare cases, surgery may be required, however low rates of success have left it a more and more abandoned practice.

A saddle pulmonary embolism can be a serious health concern and requires immediate medical treatment. While there is no surefire way to prevent the development of one, there are ways to greatly reduce risk factors that can contribute to their formation.