Sometime with thrombosis or thrombophlebitis of a deep vein, a portion of the thrombus becomes detached and travels through the veins to the right side of the heart and is then pumped into the lung circulation, where it blocks an artery in the lung. This is called pulmonary embolism.Symptoms of Pulmonary Embolism.Depending on the size of the pulmonary embolus, it can cause chest pain, shortness of breath, or cough (that may produce blood-streaked sputum). In extreme cases, loss of consciousness or even sudden death may occur.Pulmonary embolism may not be suspected, especially if the person has heart and lung disease already. Prompt diagnosis is critical, because about 10 percent of people with pulmonary embolism die within the first hour.Who Is Affected by Pulmonary Embolism? Your risk of having a pulmonary embolus increases if you are confined or immobile for prolonged periods, in other words, the same conditions that are likely to cause deep venous thrombosis or thrombophlebitis. The most likely times for pulmonary embolism to occur are after surgery, stroke, heart attack, hip or leg fracture, or prolonged bed rest or inactivity (such as sitting for a long time in a plane or car). Your risk is also higher if you are overweight or if your blood has an abnormally high tendency to clot.*208\252\8*
Archive for the ‘Cardio & Blood-Cholesterol’ Category
The nutritional care of the patient who has sustained a myocardial infarction must be tailored to the individual’s needs. It must include planning for the acute illness, the period of convalescence, and following recovery. Several factors must be considered in planning for the patient’s diet, namely shortness of breath, fatigue, abdominal distention, the presence or absence of edema, loss of appetite, and fear of eating.
An essential characteristic of therapy in acute myocardial infarction is rest. A regimen of nutritional care has been described by Christakis and Winston, and is summarized as follows.
Acute illness
For the first 24 to 48 hours the physician may direct that no food be given by mouth. Then a low-fat liquid diet supplying 500 to 800 kcal (1000 to 1500 ml fluid) is used for two or three days – longer if arrhythmia persists. This diet can include clear soups, weak tea, decaffeinated coffee, ginger ale, fruit juices, and skim milk. Very hot and very cold liquids should be avoided. Only small amounts of liquid are given at one time. The possibility that milk may produce distention because of lactose intolerance should be kept in mind.
Generally it has been considered advisable to feed the acutely ill patient. A recent study, however, has shown that it made little difference whether the patient was fed, or fed himself. Men, especially, preferred to feed themselves.
Within a few days the patient usually progresses to a soft diet with these characteristics:
1. 1000 to 1200 kcal so that there is minimum circulation required for the digestive-absorptive processes, and to initiate weight loss if obese.
2. Five to six small, easily digested meals, especially if the patient is dyspneic or has angina.
3. Cholesterol restricted to 300 mg.
4. Low in saturated fat with an increased proportion of polyunsaturated fatty acids.
5. Restricted in sodium if there is congestive heart failure.
6. Avoidance of distending foods.
When diuretics are given to the patient with congestive heart failure, the potassium loss may be increased. The physician may request the inclusion of more potassium-rich foods such as plums, prunes, orange juice, potatoes, and other vegetables. The use of a potassium salt as medication is a more reliable way to assure compensation for the losses.
Maintenance diet
As the patient adjusts once again to a normal pattern of living, his diet is based upon his weight status and the blood lipid levels. Gradual weight loss is indicated if the patient is obese; however, some patients do not respond well, physically or psychologically, to weight-losing regimens. A maintenance diet that is restricted to 300 mg cholesterol and that is reduced in its saturated fatty acid content may be useful in reducing the likelihood of a recurrence of the coronary. The selection of the diet to be used on a long-term basis is best determined by the levels of the blood cholesterol and triglycerides about 6 months to a year following the heart attack.
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