What is a pulmonary embolism?
A pulmonary embolism (PE) is a serious condition that occurs when a blood clot, typically from the legs (deep vein thrombosis) travels through the bloodstream and lodges in the pulmonary arteries, which supply blood to the lungs. This can obstruct blood flow and may lead to life-threatening complications if not promptly treated.
What causes a pulmonary embolism?
A pulmonary embolism occurs when a foreign clump of material, often a blood clot, gets stuck in an artery in the lungs, blocking the flow of blood. In many cases, multiple clots are involved. Occasionally, blockages can be caused by other substances, such as:
- Fat from the inside of a broken long bone.
- Part of a tumor.
- Air bubbles.
If you or your family have a history of blood clots, you have an increased risk of developing a pulmonary embolism. Other medical conditions and treatments can also put you at risk, including:
- Heart disease, specifically heart failure.
- Certain cancers, especially brain, ovary, pancreas, colon, stomach, lung and kidney cancers can increase your risk. Chemotherapy also further increases your risk.
- Surgery is one of the leading causes for blood clots.
- Certain genetic disorders, such as kidney disease, increase your risk.
Other risk factors include:
- Extended periods of bed rest.
- Long trips of sitting.
- Smoking.
- Being overweight.
- Pregnancy.
What are symptoms of a pulmonary embolism?
In some cases, pulmonary embolism symptoms can be subtle and range from mild to severe. The most common symptoms include:
- Unexplained and rapid onset of shortness of breath, especially after physical activity or prolonged inactivity.
- Chest pain that worsens with deep breathing, coughing or movement.
- Fainting as a result of blood pressure drops.
- Excessive sweating.
- Clammy or discolored skin.
- Coughing up blood or pink, frothy mucus.
- Rapid or irregular heartbeat.
- Leg swelling, pain, or tenderness.
If you or someone you know experiences any of these symptoms, seek immediate medical attention. Pulmonary embolisms require urgent medical intervention to prevent life-threatening complications.
How is a pulmonary embolism diagnosed?
To diagnose a pulmonary embolism, your provider will review your medical history and perform a physical examination. Often times, a pulmonary embolism can be difficult to diagnose, especially if you have underlying heart or lung disease. In this case, additional tests may be needed:
- Blood tests – measures the amount of oxygen and carbon dioxide in your blood, which can be lowered due a blood clot. It will also detect your levels of clot-dissolving substance D dimer. Higher levels of D dimer can indicate an increased likelihood of blood clots.
- Chest X-ray – used to rule out other conditions with symptoms like pulmonary embolisms.
- Ultrasound – uses sound waves to scan veins and check for deep vein blood clots.
- CT scan – creates 3D images that can find changes within the arteries in your lungs.
- Pulmonary angiogram – provides a clear picture of the blood flow in the arteries of your lungs.
- MRI – creates detailed images of the organs and tissues in your body.
How is a pulmonary embolism treated?
Treatment for a pulmonary embolism aims to keep the blood clot from getting bigger and preventing new clots from forming. Early treatment is important to prevent serious complications, or even death. The most common forms of treatment include:
- Medication, including different types of blood thinners and clot dissolvers.
- Clot removal.
- Vein filter to keep clots from going to your lungs.
Removing a pulmonary embolism does not mean they won’t come back. In fact, if you have had a PE, you may be at risk of another deep vein thrombosis or PE. It is important to continue treatment as recommended by your provider and keep regular visits to prevent or treat complications.
How can I prevent a pulmonary embolism?
Preventing pulmonary embolisms starts with preventing clots in the deep veins in your legs. The most common ways you can prevent PE include:
- Taking blood thinner medication.
- Wearing compression stockings to help the veins and leg muscles move blood more efficiently.
- Elevating your legs when possible and during the night.
- Moving as soon as possible after surgery to help prevent PE.
Traveling, especially long distances, can be a risk for developing blood clots. Although rare, you should take precautions to help prevent them during travel:
- Drink plenty of fluids.
- Take a break from sitting.
- Move in your seat every 15 to 30 minutes.
- Wear support stockings or compression socks.