What Is Pulmonary Embolism?
Pulmonary Embolism (PE) occurs when a blood clot, usually originating from a deep vein in the leg (a condition known as Deep Venous Thrombosis or DVT), travels to the lungs and blocks one or more pulmonary arteries.
This blockage prevents blood from reaching parts of the lungs, reducing oxygen levels in the body and putting strain on the heart.
A pulmonary embolism is a medical emergency that requires immediate evaluation and treatment to restore circulation and prevent complications.
What Are the Symptoms of Pulmonary Embolism?
The symptoms of PE can appear suddenly and vary depending on the size of the clot and how much of the lung is affected.
Common signs include:
- Sudden shortness of breath
- Sharp chest pain that worsens when breathing deeply
- Rapid or irregular heartbeat
- Coughing up blood
- Feeling lightheaded, faint, or dizzy
- Low oxygen levels or bluish lips and skin
Because PE can occur without warning, any sudden combination of chest pain and breathlessness should be treated as an emergency.
What Causes Pulmonary Embolism?
Most pulmonary embolisms are caused by blood clots that form in the deep veins of the legs and travel upwards through the bloodstream to the lungs.
This process is often referred to as venous thromboembolism (VTE), a collective term for both DVT and PE.
Common risk factors include:
- Prolonged inactivity (such as long-haul flights or hospital stays)
- Surgery or trauma to the legs or pelvis
- Cancer or cancer treatment
- Hormonal therapy or oral contraceptive use
- Pregnancy and the postpartum period
- Obesity and smoking
- Family history of blood clots
Identifying and managing these risk factors early can help prevent PE.
How Do Doctors Diagnose Pulmonary Embolism?
Diagnosis begins with a physical assessment and review of symptoms. Because PE can be life-threatening, tests are often performed urgently.
Common diagnostic tests include:
- CT Pulmonary Angiography (CTPA): The primary imaging test to confirm a clot in the lungs.
- D-dimer Blood Test: Measures clot-related proteins in the blood; elevated levels may suggest an active clot.
- Echocardiogram: Checks for strain on the heart caused by the blockage.
- Doppler Ultrasound: Identifies any existing clots in the leg veins that may have caused the PE.
These tests help doctors confirm the diagnosis and guide immediate treatment.
Is Pulmonary Embolism Life-Threatening?
Yes. Pulmonary embolism can restrict blood flow to the lungs and place severe stress on the heart. Without timely treatment, it may cause low oxygen levels, heart failure, or even sudden death.
However, with prompt medical care and ongoing monitoring, most patients recover fully and can prevent recurrence with proper follow-up.
How Is Pulmonary Embolism Treated?
Treatment aims to dissolve the clot, prevent new ones from forming, and stabilise breathing and heart function.
1. Medications
- Anticoagulants (blood thinners): The mainstay of treatment to stop new clots from forming.
- Thrombolytics (clot-dissolving drugs): Used in severe cases to rapidly break down existing clots.
2. Interventional procedures
- Catheter-directed therapy: Inserting a thin tube to deliver medication directly to the clot.
- Inferior vena cava (IVC) filter: A small device placed in the main vein to trap clots before they reach the lungs, used selectively in patients who cannot take blood thinners.
3. Supportive care
Oxygen therapy, pain control, and heart monitoring are often part of initial management.
Can Pulmonary Embolism Be Prevented?
Yes. Prevention focuses on reducing clot formation, especially in people at higher risk. You can:
- Stay active and avoid prolonged sitting or bed rest
- Move your legs during long flights or car rides
- Follow your doctor’s advice after surgery (including use of compression stockings or preventive medication)
- Maintain a healthy weight and quit smoking
If you’ve had a previous DVT or PE, your cardiologist may recommend ongoing medication to prevent recurrence.
When Should You See a Cardiologist or Seek Emergency Care?
Go to the nearest emergency department if you experience:
- Sudden shortness of breath
- Chest pain that worsens when breathing
- Fainting, lightheadedness, or rapid heartbeat
Even if symptoms improve quickly, evaluation is necessary to prevent future episodes.
Frequently Asked Questions (FAQs)
1. Can pulmonary embolism go away on its own? Small clots may dissolve naturally, but medical treatment is crucial to prevent recurrence and complications.
2. How long do you need treatment after a PE? Most patients need anticoagulants for 3–6 months, though some may require longer-term therapy depending on their risk factors.
3. Is pulmonary embolism the same as a heart attack? No. A heart attack occurs when blood flow to the heart is blocked, while a pulmonary embolism blocks blood flow in the lungs.
4. Can you fly after having a pulmonary embolism? Flying may increase risk of recurrence in the short term. Always consult your doctor before air travel after a PE.
5. What is the long-term outlook after PE? With timely treatment and follow-up, most people recover well. Long-term monitoring helps reduce the chance of recurrence.
