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.
Whenever a young and healthy athlete gets sick, it always gets the attention
of the press. The news is even more dramatic when the condition can be
life-threatening, as in the case of Serena Williams, who reportedly developed a
pulmonary
embolism in late February 2011. While it is possible to recover fully from a
pulmonary embolism, it is indeed a serious condition and requires serious medications. In addition, Ms. Williams
also reportedly required treatment for a
hematoma, a collection of clotted blood
that forms outside of a blood vessel.
A pulmonary embolism (PE) happens when a blood clot (thrombus) forms in the one of the body's large veins (known as deep vein thrombosis or DVT), breaks off, and travels (embolizes) in the circulatory system back to the heart and out into the arteries that carry blood to the lungs to load up oxygen. There the clot in the lungs (embolus) then clogs the artery that provides blood supply to part of the lung, preventing the normal exchange of oxygen and carbon dioxide. It also reduces the blood supply to the lung tissue itself. Lung tissue can die (infarct) if circulation is impaired.
Essentially anything that increases the potential for blood clots to form in
the veins can increase your chances of developing a pulmonary embolus. While
some medications and chronic medical problems can increase the tendency of blood
to clot, even those who are healthy and fit can be at risk for pulmonary
embolism due to prolonged immobilization (as with extended car or plane travel
or hospitalization and bed rest) or circumstances that damage the blood vessel
walls, making a clot more likely to form. Surgery and trauma to the leg are
examples of conditions that can make a vein more likely to clot. Sudden
chest
pain and shortness of breath are the main symptoms of pulmonary embolism, but
coughing may also occur. The pain is usually worse when taking a breath (known
as pleurisy). The affected individual may have signs such as a
blue-tinged
discoloration of the skin and feel
lightheaded or
weak. In severe cases, the
heart stops beating and sudden death results. Fortunately, treatment for
pulmonary embolism is available, and most patients survive when appropriately
diagnosed and treated with anti-clotting drugs. A higher incidence of death from
pulmonary embolism occurs in patients who are older, have other underlying
illnesses, or have a delay in diagnosis.
The lungs are a pair of organs in the chest that are primarily responsible
for the exchange of oxygen and carbon dioxide between the air we breathe and blood. The lung is composed of clusters of small air sacs (alveoli) divided by
thin, elastic walls (membranes). Capillaries, the tiniest of blood vessels, run
within these membranes between the alveoli and allow blood and air to come near each
other. The distance between the air in the lungs and the blood in the
capillaries is very small, and allows molecules of oxygen and carbon dioxide to
transfer across the membranes.
The exchange of the air between the lungs and blood are through the arterial
and venous system. Arteries and veins both carry and move blood throughout the
body, but the process for each is very different.
Arteries carry blood from the heart
to the body.
Veins return blood from the body to the heart.
The heart is a
two-sided pump.
Oxygen-carrying blood travels from the left side of the heart to
all the tissues of the body. The oxygen is extracted by the tissue, and carbon
dioxide (a waste product) is delivered back into the blood.
The blood, now
deoxygenated and with higher levels of carbon dioxide, is returned via the veins to
the right side of the heart.
The blood is then pumped out of the right side of the
heart to the lungs, where the carbon dioxide is removed and oxygen is returned
to the blood from the air we breathe in, which fills the lungs.
Now the blood, high in oxygen and low in carbon
dioxide, is returned to the left side of the heart where the process starts all
over again.
The blood travels in a circle and is therefore referred to as
circulation.
If a blood clot (thrombus) forms in the one of the body's veins (deep
vein thrombosis or DVT), it has the potential to break off and enter the
circulatory system and travel (or embolize) through the heart and become lodged in the one of the branches
of the pulmonary artery of the lung. A clot that travels through the circulatory
system
to another location is known as an embolus (plural emboli).
A pulmonary embolus clogs the artery that provides blood supply to part of
the lung. The embolus not only prevents the exchange of oxygen and carbon
dioxide, but it also decreases blood supply to the lung tissue itself,
potentially causing lung tissue to die (infarct).
A pulmonary embolus is one of the life-threatening causes of chest pain and
should always be considered when a patient presents to a healthcare provider
with complaints of chest pain and shortness of breath.
Non-thrombus causes of pulmonary embolus are rare but include:
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.
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.
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.
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.
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.
A computerized axial tomography scan is an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Computerized axial tomography is more commonly known by its abbreviated names, CT scan or CAT scan. A CT scan is used to define normal and abnormal structures in the body and/or assist in procedures by helping to accurately guide the placement of instruments or treatments.
A large donut-shaped x-ray machine takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In each of these pictures the body is seen as an x-ray "slice" of the body, which is recorded on a film. This recorded image is called a tomogram. "Computerized Axial Tomography" refers to the recorded tomogram "sections" at different levels of the bod...