A pulmonary embolism occurs when a blood clot blocks one or more arteries in the lungs and is a serious and potentially life-threatening condition. It can interfere with blood flow to the lungs, reducing oxygen supply to the rest of the body. In some cases, pulmonary embolism can cause permanent damage to the heart or lungs, or even result in death.
Deep vein thrombosis (DVT) is a condition in which a blood clot forms in a deep vein in the leg, which is often the cause of pulmonary embolism. Blood flow in the vein can be slowed or disrupted by factors such as: clots can break off and travel to the lungs, where they can lodge in pulmonary arteries.
Prolonged immobility, such as bed rest, long flights, or sitting for a long time
Surgery, especially orthopedic or abdominal surgery
Injury or trauma to the leg or pelvis
Pregnancy or childbirth
Cancer or chemotherapy
Hormonal therapy or birth control pills
Smoking
Obesity
Genetic or inherited blood clotting disorders
Sometimes, pulmonary embolism can be caused by other substances that block the pulmonary arteries, such as:
Fat from a broken bone
Air bubbles from a medical procedure
Amniotic fluid from childbirth
Tumor cells or parasites
The symptoms of pulmonary embolism can vary depending on the size and location of the clot, and the presence of any underlying lung or heart disease. Some of the common symptoms include:
Shortness of breath that occurs suddenly and worsens with exertion
Chest pain that feels like a heart attack, sharp, and worsens with breathing, coughing, or bending
Cough that may produce blood or blood-streaked mucus
Rapid or irregular heartbeat
Dizziness or fainting
Sweating
Fever
Leg pain or swelling, usually in the calf
Discolored or clammy skin
People with pulmonary embolism may not experience any symptoms, or may experience mild or nonspecific symptoms that are misdiagnosed as other conditions. When you suspect you may be suffering from pulmonary embolism or have any of the risk factors for blood clots, it is crucial to seek medical attention immediately.
To confirm the diagnosis, your doctor will ask you about your medical history, perform a physical examination, and order some tests, including:
Blood tests to measure the level of a substance called D-dimer, which is released when a clot dissolves, or to check for any inherited clotting disorders or oxygen and carbon dioxide levels in your blood
Chest X-ray to rule out other causes of chest pain or shortness of breath, such as pneumonia or pneumothorax
Ultrasound to scan the veins in your legs and look for any signs of DVT
CT pulmonary angiography to create a 3D image of the pulmonary arteries and detect any clots or abnormalities
Ventilation-perfusion scan to examine the airflow and blood flow in your lungs and compare them
Pulmonary angiogram to inject a dye into the pulmonary arteries and take X-rays to show the blood flow and any blockages
Pulmonary embolism treatment focuses on preventing the clot from growing, dissolving the existing clot, and preventing new clots from forming. Treatment options include:
Medications, such as anticoagulants (blood thinners) that prevent further clotting, or thrombolytics (clot busters) that dissolve the clot
Procedures, such as surgical embolectomy to remove a large or life-threatening clot, or catheter-directed thrombolysis to deliver a clot-busting drug directly to the clot
Devices, such as a vena cava filter to trap any clots that may break off from the legs and prevent them from reaching the lungs, or a balloon pulmonary angioplasty to widen a narrowed pulmonary artery
The choice of treatment depends on the severity of the condition, the risk of bleeding, and the individual factors of the patient. The treatment may require hospitalization, monitoring, and follow-up care.
Pulmonary embolism can be prevented by reducing the risk of developing blood clots in the legs. Some of the preventive measures include:
Moving your legs frequently, especially during long periods of immobility, such as travel, bed rest, or sitting
Wearing compression stockings or pneumatic devices to improve the blood circulation in your legs
Taking anticoagulant medications as prescribed by your doctor, especially if you have a history of blood clots or a high risk of developing them
Drinking plenty of fluids and avoiding dehydration
Quitting smoking and maintaining a healthy weight
Seeking medical attention if you have any signs or symptoms of DVT or pulmonary embolism
The causes, symptoms, diagnosis, treatment, and prevention of pulmonary embolism can protect you and your loved ones from this potentially fatal condition.
