Summary about Disease
Lung infarction refers to the death of lung tissue due to a lack of blood supply. It typically occurs as a consequence of pulmonary embolism, where a blood clot travels to the lungs and blocks a pulmonary artery or its branches, depriving the lung tissue of oxygen. Lung infarction can lead to pain, difficulty breathing, and other respiratory complications.
Symptoms
Common symptoms of lung infarction include:
Pleuritic chest pain (sharp pain that worsens with breathing)
Shortness of breath (dyspnea)
Cough (may produce blood-tinged sputum - hemoptysis)
Fever
Rapid heart rate (tachycardia)
Rapid breathing (tachypnea)
Sweating
Anxiety
Causes
The primary cause of lung infarction is pulmonary embolism (PE). Risk factors for PE, and therefore lung infarction, include:
Deep vein thrombosis (DVT)
Prolonged immobility (e.g., long flights, bed rest)
Surgery (especially orthopedic)
Cancer
Hypercoagulable states (e.g., factor V Leiden, protein C or S deficiency)
Pregnancy
Oral contraceptives or hormone replacement therapy
Trauma
Medicine Used
The mainstays of treatment for lung infarction focus on addressing the underlying pulmonary embolism:
Anticoagulants: These medications prevent further clot formation and allow the body to break down existing clots. Examples include heparin (unfractionated or low molecular weight), warfarin, direct oral anticoagulants (DOACs) like rivaroxaban, apixaban, edoxaban, and dabigatran.
Thrombolytics: In severe cases with massive PE, thrombolytic drugs (e.g., alteplase, streptokinase) may be used to dissolve the clot rapidly. However, they carry a higher risk of bleeding.
Pain Relief: Analgesics may be prescribed to manage chest pain.
Oxygen Therapy: Supplemental oxygen is often needed to improve oxygen levels in the blood.
Is Communicable
Lung infarction is not communicable. It is a result of a blockage within the pulmonary vasculature and is not caused by an infectious agent.
Precautions
Precautions focus on preventing pulmonary embolism, which is the primary cause of lung infarction. These include:
For individuals at risk:
Anticoagulant medications (as prescribed by a doctor).
Compression stockings, especially during prolonged immobility.
Regular leg exercises during long periods of sitting or lying down.
Avoiding prolonged immobility when possible.
Maintaining a healthy weight.
Post-surgery:
Early ambulation after surgery.
Prophylactic anticoagulation.
How long does an outbreak last?
Lung infarction is not an outbreak-related disease. Each event is related to an individual case of pulmonary embolism. Resolution depends on the size and location of the infarct, the effectiveness of treatment (anticoagulation), and the individual's overall health.
How is it diagnosed?
Diagnosis of lung infarction involves a combination of clinical assessment and imaging studies:
Clinical Evaluation: Includes a thorough medical history, physical examination, and assessment of symptoms.
Chest X-ray: May show infiltrates or consolidation in the affected area.
CT Pulmonary Angiogram (CTPA): The gold standard for diagnosing pulmonary embolism; visualizes blood clots in the pulmonary arteries.
Ventilation-Perfusion (V/Q) Scan: An alternative to CTPA, especially in patients with kidney problems.
Blood Tests: D-dimer levels can be elevated in the presence of a blood clot. Arterial blood gas analysis may show low oxygen levels.
ECG: While not diagnostic, ECG changes may suggest pulmonary embolism.
Timeline of Symptoms
The onset of symptoms can vary. In acute pulmonary embolism leading to infarction:
Sudden onset: Chest pain, shortness of breath, and cough typically begin suddenly.
Hours to days: Symptoms may worsen over a few hours or days. Fever, rapid heart rate, and hemoptysis may develop.
Resolution: With appropriate treatment, symptoms gradually improve over days to weeks. However, some residual scarring or lung damage may persist.
Important Considerations
Early Diagnosis and Treatment: Prompt diagnosis and treatment of pulmonary embolism are crucial to prevent or minimize lung infarction.
Underlying Risk Factors: Identifying and managing risk factors for venous thromboembolism is essential in preventing recurrent events.
Differential Diagnosis: Lung infarction should be differentiated from other conditions causing chest pain and respiratory distress, such as pneumonia, pleurisy, and myocardial infarction.
Complications: Potential complications include pulmonary hypertension, pleural effusion, and empyema.
Follow-up: Patients require close follow-up to monitor for complications and adjust anticoagulation therapy as needed.